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1

A Case Report of Testicular Sparganosis Misdiagnosed as Testicular Tumor  

PubMed Central

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent. Graphical Abstract

2014-01-01

2

Pulmonary sparganosis mansoni: a case report from a non-endemic region  

PubMed Central

Sparganosis mansoni is a parasitic disease caused by the larva of Spirometra mansoni. It occurs worldwide, but only a few patients show pulmonary involvement. Here, we present a case of pulmonary sparganosis mansoni in a non-endemic region. A 32-year-old Chinese woman presented with intermittent bloody phlegm, peripheral blood eosinophilia, and migratory patch shadows in both lungs. She had been misdiagnosed with eosinophilic pneumonia. She had a history of eating raw frogs, and the sparganum mansoni antibody was positive in both her blood and bronchoalveolar lavage fluid. Several sparganum mansoni were found in a frog sample that the patient provided. Consequently, she was diagnosed with pulmonary sparganosis mansoni. After two oral courses of praziquantel were administered, her symptoms and radiological lesions improved significantly. To our knowledge, this is the first case of pulmonary sparganosis mansoni occuring in Shanghai. Oral praziquantel is effective for the treatment of sparganosis mansoni, although its course of therapy may need to be repeated.

Cheng, Ke-Bin; Gao, Bei-Lan; Liu, Jin-Ming

2014-01-01

3

Ocular sparganosis mimicking an orbital idiopathic inflammatory syndrome.  

PubMed

Sparganosis is an infection by the parasitic tapeworm larvae of Spirometra species. Ocular sparganosis is a rare disease that is easily misdiagnosed. We reported a rare case of ocular sparganosis mimicking orbital idiopathic inflammatory syndrome at initial presentation. A 34-year-old female presented with rapid progressive swelling of her left eyelid and mild proptosis for the duration of one month. The other ocular examinations were normal and the thyroid function was normal. Magnetic resonance imaging revealed a fusiform enlargement and mild heterogenous enhancement of the superior oblique muscle of the left orbit. First she received prednisolone therapy and the proptosis partially improved. Six months later, a white, flat and wrinkled string like worm wriggled out from the caruncular conjunctiva of the left eye. The pathology results confirmed that the worm was a Spirometra species larva. After removal of the larva and treatment with praziquantel, the proptosis was resolved without recurrence. Ocular sparganosis is a rare disease and only a few case reports have been reported. The drug therapy has not been effective and the surgical removal is the principal therapy. Despite its rarity, ocular sparganosis should be considered as a possible cause of orbital inflammation in patients. PMID:24215169

Ho, Tsai-Hsuan; Lin, Muh-Chiou; Yu, Wei-Wen; Lai, Ping-Hong; Sheu, Shwu-Jiuan; Bee, Youn-Shen

2013-12-01

4

Pulmonary sparganosis mansoni: a case report from a non-endemic region.  

PubMed

Sparganosis mansoni is a parasitic disease caused by the larva of Spirometra mansoni. It occurs worldwide, but only a few patients show pulmonary involvement. Here, we present a case of pulmonary sparganosis mansoni in a non-endemic region. A 32-year-old Chinese woman presented with intermittent bloody phlegm, peripheral blood eosinophilia, and migratory patch shadows in both lungs. She had been misdiagnosed with eosinophilic pneumonia. She had a history of eating raw frogs, and the sparganum mansoni antibody was positive in both her blood and bronchoalveolar lavage fluid. Several sparganum mansoni were found in a frog sample that the patient provided. Consequently, she was diagnosed with pulmonary sparganosis mansoni. After two oral courses of praziquantel were administered, her symptoms and radiological lesions improved significantly. To our knowledge, this is the first case of pulmonary sparganosis mansoni occuring in Shanghai. Oral praziquantel is effective for the treatment of sparganosis mansoni, although its course of therapy may need to be repeated. PMID:24977019

Cheng, Ke-Bin; Gao, Bei-Lan; Liu, Jin-Ming; Xu, Jin-Fu

2014-06-01

5

Subcutaneous Sparganosis - a Case Report.  

National Technical Information Service (NTIS)

Sparganosis on Taiwan, in most cases, is considered to be due to infections with the spargana or pleurocercoid larva of Diphyllobothrium mansoni, a common intestinal tapeworm of dogs and cats. Humans can become infected with the larval worms by either acc...

T. Y. Chen J. H. Cross

1975-01-01

6

Severe sparganosis in Australian tree frogs.  

PubMed

Spargana of Spirometra erinacei infect many vertebrate species, but severe disease from sparganosis has been reported from few host species. Information on the effects of this common, introduced tapeworm of cats on Australian frogs is lacking. Our survey to detect significant diseases in free-ranging amphibians in eastern Australia between 1993 and 2000 revealed that infection with spargana (plerocercoids) of S. erinacei occurred in 12/243 (4.9%) sick frogs. Infections occurred in skeletal muscle and subcutis, especially the thighs, of large adults of Litoria caerulea, Litoria aurea, Litoria gracilenta, and Litoria peronii. Three frogs were also infected in the coelomic cavity. Heavy burdens in seven frogs were associated with poor body condition and debilitating lesions, whereas lighter infections in five sick frogs were considered likely to be incidental to other diseases. In severe infections, a large proportion of thigh muscle was replaced with spargana and various amounts of fibrosis, and some frogs also had myonecrosis, granulomatous inflammation, hemorrhage, and skin ulceration. Concurrent infections were common. Our findings suggest sparganosis is one of a few currently recognized serious diseases affecting free-ranging frogs in Australia. PMID:19901368

Berger, Lee; Skerratt, Lee F; Zhu, Xing-Quan; Young, Sam; Speare, Rick

2009-10-01

7

Fournier's gangrene associated with sparganosis in the scrotum.  

PubMed

Fournier's gangrene is a necrotizing fasciitis of the scrotum or perineum that may extend by way of the fascial planes to the penis and the anterior abdominal wall up to the clavicles, buttocks, or lower extremities. It is a life-threatening progressive disease that requires aggressive antibiotic therapy and early radical debridement. Sparganosis is a parasitic infection that occurs principally in cats and dogs, but human infestations have been reported, albeit rarely. Recently, we experienced a case of Fournier's gangrene associated with sparganosis in the scrotum, which was treated with antibiotics and extensive debridement including removal of a white, flat, shiny sparganum worm. PMID:14751384

Jeong, Hee Jong

2004-01-01

8

Fournier's gangrene associated with sparganosis in the scrotum  

Microsoft Academic Search

Fournier's gangrene is a necrotizing fasciitis of the scrotum or perineum that may extend by way of the fascial planes to the penis and the anterior abdominal wall up to the clavicles, buttocks, or lower extremities. It is a life-threatening progressive disease that requires aggressive antibiotic therapy and early radical debridement. Sparganosis is a parasitic infection that occurs principally in

Hee Jong Jeong

2004-01-01

9

Angiomyofibroblastoma of the vulva.  

PubMed

Angiomyofibroblastoma (AMFB) is an uncommon benign mesenchymal tumor. AMFB occurs almost in the vulvo-vaginal area of women. The gross features of AMFB are well-circumscribed so it clinically is often thought as Bartholin gland cyst or aggressive angiomyxoma. Usually, most tumors grow slowly, and patients do not feel pain. It also has low tendency for local recurrence. The histologic findings of the tumors are abundant thin-walled blood vessels with hypocellular and hypercellular areas. Almost all tumor cells have immunoreactivity for both desmin and vimentin. It also has estrogen and/or progesterone receptors, but staining for cytokeratin is negative. Here is a case of AMFB of the vulva occurring in a 40-year-old woman, involving the right labia majora. The patient described that her vulva mass grew in about few months. The maximum dimension of the tumor was measured as 2 cm, and we resected the tumor one month after as her second visit. PMID:24328028

Seo, Jung-Won; Lee, Kyoung-A; Yoon, Na-Ra; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

2013-09-01

10

Aggressive angiomyxoma of the vulva: a précis for primary care providers.  

PubMed

Vulvar aggressive angiomyxoma (AA) is a rare mesenchymal tumor of the vulva. Due to its slow-growing nature, it is often overlooked and misdiagnosed by primary care providers (PCPs). We describe a case report of vulvar AA in a 38-year-old woman who underwent complete surgical excision of the neoplasm with no evidence of recurrence on a 5-year followup. A literature review follows to provide PCPs with the clinical, radiologic, and pathologic features that this tumor displays. PMID:24073346

Elkattah, R; Sarkodie, O; Otteno, H; Fletcher, A

2013-01-01

11

Aggressive Angiomyxoma of the Vulva: A Pr?cis for Primary Care Providers  

PubMed Central

Vulvar aggressive angiomyxoma (AA) is a rare mesenchymal tumor of the vulva. Due to its slow-growing nature, it is often overlooked and misdiagnosed by primary care providers (PCPs). We describe a case report of vulvar AA in a 38-year-old woman who underwent complete surgical excision of the neoplasm with no evidence of recurrence on a 5-year followup. A literature review follows to provide PCPs with the clinical, radiologic, and pathologic features that this tumor displays.

Elkattah, R.; Sarkodie, O.; Otteno, H.; Fletcher, A.

2013-01-01

12

Solitary Mastocytoma of the Vulva  

PubMed Central

Solitary mastocytoma of the skin is a rare tumor. Its occurrence in the vulva is extremely rare with only few case reports in the literature. We report a solitary mastocytoma of the vulva in a 10-year-old girl. Her systemic examination was unremarkable. The clinical and histopathological features were consistent with the diagnosis of solitary mastocytoma of the vulva. The follow-up after surgical excision was uneventful. The purpose of this communication is (i) to report a case of solitary mastocytoma occurring in an unusual site, the vulva and to show that (ii) in this case age at presentation is 10 years with infancy as common age of presentation of solitary mastocytoma, and to show that (iii) in appropriate setting this should be included in the differential diagnosis of vulval swelling.

Velusamy, Shasi; Karuthedath Areeppurath Mana, Jayasree; Mathew, Chalissery Francis

2014-01-01

13

Angiofibroma of the vulva.  

PubMed

Background:Cellular angiofibroma is a benign and rare tumor. It usually arises in middle-aged women and involves the vulva. Complete local excision of the tumor is the best cure, and, usually, there is no recurrence after surgery.Case Report:We describe a 20-year-old woman with a painless, growing vulvar mass who presented about 3 years ago. Her past medical history was negative for oral contraceptives, tobacco, and alcohol, and there were no similar lesions in her family history. A physical examination revealed two masses on the right and the left labia majora and similar lesions on the left axilla and both breasts. An uncomplicated simple resection of the vulvar masses was done in the operating room. There was no evidence of recurrence 12 months after surgery. Histopathologic examination revealed that the findings were consistent with the diagnosis of the cellular angiofibroma. Based on our knowledge, this patient is the youngest case of vulvar angiofibroma. The lesions were large and symmetrical (on both labia majora), although they differed in size. Extravulvar (breast and axilla) lesions were also noteworthy in this patient. PMID:24800710

Ahmadnia, Hassan; Kamalati, Ali; Dolati, Mahmood; Akhavan Rezayat, Alireza; Katebi, Mehrdad

2014-01-01

14

[Lipedema: a misdiagnosed entity].  

PubMed

Lipedema is a clinical entity frequently misdiagnosed or confound with primary lymphedema. Lipedema is a disorder of adipose tissue that occurs almost exclusively in obese women. It is characterized by bilateral enlargement from hip to ankle due to abnormal depositions of subcutaneous fat associated with often mild edema, usually sparing the feet. Disease onset is usually at or soon after puberty. Lipedema results in considerable frustration and distress resulting from the cosmetic appearance. Patients may complain of pain, tenderness, easy bruising of the affected areas with moderate to severe sensitivity to digital pressure or pinching. Imaging studies using computed tomography, magnetic resonance imaging, ultrasound, lymphoscintigraphy are not indicated, except if the diagnosis is atypic or doubtful. Long-term evolution may alter lymphatic system and lead to a lipo-lymphedema with specific complications such as cellulitis. Lipedema management is not codified and included weight loss (poorly improving leg appearance or discomfort), psychological counselling and compression therapy. Liposuction, especially using tumescent local anaesthesia, may reduce edema, spontaneous pain, sensitivity to pressure, bruising and improve appearance resulting in a important increase in quality of life. PMID:22698628

Vignes, S

2012-07-01

15

Molecular Diagnosis of Subcutaneous Spirometra erinaceieuropaei Sparganosis in a Japanese Immigrant  

PubMed Central

We report a case of subcutaneous sparganosis in a 68-year-old female Japanese immigrant in Germany. The patient complained of a painless erythema caudal of the umbilicus with a palpable subcutaneous cherry-sized lump. Polymerase chain reaction on formalin-fixed parasite tissue identified Spirometra erinaceieuropaei as the causative agent; the proliferative form of sparganosis, which is caused by the branching and disseminating Sparganum proliferum, could, thus, be excluded. From the excised sparganum, an immunofluorescence test was established and revealed an antibody response directed against the parasite's tegument. Histological key features of the plerocercoid that facilitate diagnosis with different stains are presented.

Tappe, Dennis; Berger, Luise; Haeupler, Alexandra; Muntau, Birgit; Racz, Paul; Harder, Yves; Specht, Katja; Prazeres da Costa, Clarissa; Poppert, Sven

2013-01-01

16

Primary milia localized to the vulva.  

PubMed

Multiple primary milia were found on the vulva of a 52-year-old woman who was referred to the dermatology clinic by her gynecologist. These lesions are commonly distributed on the face and rarely occur in this location without antecedent trauma. This report demonstrates the unique presentation of primary milia in the genital region and explores the diagnostic features and treatment methods of these lesions. PMID:24746302

Adotama, Prince; Susa, Joseph; Glass, Donald A

2014-01-01

17

Morphogenesis of the C. elegans vulva  

PubMed Central

Understanding how cells move, change shape, and alter cellular behaviors to form organs, a process termed morphogenesis, is one of the great challenges of developmental biology. Formation of the C. elegans vulva is a powerful, simple, and experimentally accessible model for elucidating how morphogenetic processes produce an organ. In the first step of vulval development, three epithelial precursor cells divide and differentiate to generate 22 cells of seven different vulval subtypes. The 22 vulval cells then rearrange from a linear array into a tube, with each of the seven cell types undergoing characteristic morphogenetic behaviours that construct the vulva. Vulval morphogenesis entails many of the same cellular activities that underlie organogenesis and tissue formation across species, including invagination, lumen formation, oriented cell divisions, cell-cell adhesion, cell migration, cell fusion, extracellular matrix remodelling and cell invasion. Studies of vulval development have led to pioneering discoveries in a number of these processes and are beginning to bridge the gap between the pathways that specify cells and their connections to morphogenetic behaviors. The simplicity of the vulva and the experimental tools available in C. elegans will continue to make vulval morphogenesis a powerful paradigm to further our understanding of the largely mysterious mechanisms that build tissues and organs.

Schindler, Adam J

2012-01-01

18

Misdiagnosing sleep disorders as primary psychiatric conditions  

Microsoft Academic Search

Sleep disorders are relevant to psychiatric practice in a number of ways, including the possibility that they may be misdiagnosed as fundamentally psychiatric conditions in patients of all ages. This risk exists in a wide range of collectively very common sleep disorders which need to be considered in explaining insomnia, excessive sleepiness or disturbed episodes of behaviour associated with sleep

Gregory Stores

2003-01-01

19

A surgically confirmed case of breast sparganosis showing characteristic mammography and ultrasonography findings.  

PubMed

A case of breast sparganosis was confirmed by surgical excision of a worm (fragmented into 5 pieces) in a 59-year-old Korean woman suffering from a palpable mass in the left breast. Mammography and ultrasonography characteristically revealed the presence of several well-defined, isodense and hypoechoic tubular masses, in the upper quadrant of the left breast, each mass consisting of a continuous cord- or worm-like structure. During surgery, a long segment of an actively moving sparganum of Spirometra sp. and 4 small fragments of the same worm, giving a total length of 20.3 cm, were extracted from the upper outer quadrant of the left breast and the axillary region. The infection source remains unclear, because the patient denied ingesting any snake or frog meat or drinking untreated water. PMID:16809964

Park, Jae-Hwan; Chai, Jee-Won; Cho, Nariya; Paek, Nam-Sun; Guk, Sang-Mee; Shin, Eun-Hee; Chai, Jong-Yil

2006-06-01

20

A surgically confirmed case of breast sparganosis showing characteristic mammography and ultrasonography findings  

PubMed Central

A case of breast sparganosis was confirmed by surgical excision of a worm (fragmented into 5 pieces) in a 59-year-old Korean woman suffering from a palpable mass in the left breast. Mammography and ultrasonography characteristically revealed the presence of several well-defined, isodense and hypoechoic tubular masses, in the upper quadrant of the left breast, each mass consisting of a continuous cord- or worm-like structure. During surgery, a long segment of an actively moving sparganum of Spirometra sp. and 4 small fragments of the same worm, giving a total length of 20.3 cm, were extracted from the upper outer quadrant of the left breast and the axillary region. The infection source remains unclear, because the patient denied ingesting any snake or frog meat or drinking untreated water.

Park, Jae-Hwan; Chai, Jee-Won; Cho, Nariya; Paek, Nam-Sun; Guk, Sang-Mee; Shin, Eun-Hee

2006-01-01

21

Extramammary Paget's disease of the vulva.  

PubMed

Vulvar Paget's disease is an extremely rare neoplasm that accounts for less than 1% of the vulvar malignancies. We present a case of a 75-year-old woman, who had an eczematoid lesion involving the labia majora and minora bilaterally, with infiltration to the clitoris. Enlarged non-fixed lymph nodes were palpable in the inguinal region bilaterally. A biopsy of the vulva showed Paget's disease. She underwent radical vulvectomy with bilateral inguinal lymph node dissection. The patient remained disease free at 6-month follow-up. PMID:24265339

Gavriilidis, Paschalis; Chrysanthopoulos, Konstantinos; Gerasimidou, Domniki

2013-01-01

22

Merkel cell carcinoma of the vulva.  

PubMed

The authors describe the clinical and histologic findings in a case of Merkel cell carcinoma of the vulva, which was associated with squamous cell carcinoma in situ and lichen sclerosus. Electron microscopy of the tumor revealed membrane-bound granules. At postmortem examination, metastases from this primary skin tumor were found in the pelvic lymph nodes, in paraortic lymph nodes, in the liver, and in vertebral bodies. The case is unusual because Merkel cell tumors are usually found on the face or the extremities and seldom metastasize widely. PMID:6322075

Bottles, K; Lacey, C G; Goldberg, J; Lanner-Cusin, K; Hom, J; Miller, T R

1984-03-01

23

Acute vulvar pain in a lady with post circumcision inclusion cyst of the vulva containing stones: a case report  

PubMed Central

Background Despite global eradication efforts, female genital cutting is still deep routed practice in some parts of Asia and East Africa. The crude and unscientific natures of the practice lead to many complications. Epidermoid inclusion cysts of the vulva are one of the late complications of female genital cutting and typically present as painless cystic swellings. But clinical presentation as ‘stone’ containing, hard vulvar mass is reported only once in the literature and presentation with acute vulvar pain has never been documented. Case presentation A 21 yrs old, Ethiopian, unmarried, lady presented with sever acute vulvar pain, discharge, and a stony hard vulvar swelling 13 years after type-III female genital cutting (infibulation). Surgical excision of the cyst, which contained two ‘stones’ inside it, and defibulation were done. Histopathology confirmed calcified, keratinizing epidermoid inclusion cyst of the vulva. Conclusions Clinicians, in areas where female genital cutting is prevalent, should be aware of such unusual late vulvar complication of the practice which might be misdiagnosed for other solid vulvar swellings and be familiar with the appropriate management.

2014-01-01

24

The normal vulva in medical textbooks.  

PubMed

When a healthy woman expresses concerns about her vulva, the doctor's response should be informed by clinical knowledge. For many doctors, accumulation of such knowledge would have begun with undergraduate teaching and medical textbooks. The aim of this study is to examine the information on female genital morphology in medical textbooks. A total of 59 gynaecology and anatomy textbooks were searched for information on the dimensions of vulval constitutent parts. No textbook gave measurements for all vulval structures. Vaginal length was reported in 21/59 textbooks, clitoral size in 15/59 and labia minora in 1/59. Where measurements appear, they suggest narrower ranges than recent reports. Information of vulval morphology is scanty and inaccurate in medical textbooks. The general lack of professional resources means that doctors may consciously or non-consciously rely upon personal experiences and popular culture to form their opinions, as do their patients. PMID:24127945

Andrikopoulou, M; Michala, L; Creighton, S M; Liao, L-M

2013-10-01

25

Secondary Lymphangioma of Vulva: A Report of Two Cases  

PubMed Central

Secondary lymphangiomas or acquired lymphangiomas of vulva represent dilatation of upper dermal lymphatics following damage to previously normal deep lymphatics. They have been reported to occur following various infections, surgeries and radiotherapy which can cause damage to deep lymphatics.Treatment options in the management of secondary lymphangiomas include surgical resection, carbon dioxide laser vaporisation, sclerosing agents etc. We report two cases of secondary lymphangioma of vulva that followed radiotherapy for carcinoma of cervix. Both the patients were treated successfully by surgery.

Gnanaraj, Pushpa; Revathy, V; Venugopal, V; Tamilchelvan, D; Rajagopalan, V

2012-01-01

26

A rare tumour of the vulva: a case report of a vulva angioneurofibroma hamartoma in a Cameroonian woman  

PubMed Central

We present the case of a rare vulva tumour, in a 33 years Cameroonian old woman and managed in Obstetrics and Gynecology Unit of Yaoundé Central Hospital in Cameroon. It was a painless pedunculated vulva tumour which developed over a period of six months. This gigantic rapidly growing tumour, was treated with simple surgical resection. After surgical resection, histology confirmed an angioneurofibroma hamartoma. There has been no recurrence and presently the patient is symptom-free.

Ymele, Florent Fouelifack; Bechem, Efuetnkeng; Njotang, Philip Nana; Nangue, Charlette; Fouedjio, Jeanne Hortence; Damtheou, Sadjoli; Enoh, Robinson Mbu

2013-01-01

27

Sparganosis presenting as cauda equina syndrome with molecular identification of the parasite in tissue sections.  

PubMed

A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei. PMID:24516282

Boonyasiri, Adhiratha; Cheunsuchon, Pornsuk; Srirabheebhat, Prajak; Yamasaki, Hiroshi; Maleewong, Wanchai; Intapan, Pewpan M

2013-12-01

28

A case of misdiagnose of malaria infection  

PubMed Central

A case of malaria infection in a 42-year-old woman in rural area of Mahmodabad, Mazandaran Province, North Iran was reported and discussed elaborately. She was complaining about recurrent fevers, sweating, headache and myalgia in back. After her first admission to hospital due to misdiagnose she did not receive proper treatment and the patient suffered from clinical manifestations again. Eventually in the second admission to another hospital, after a precise examination on her thick and thin blood smear the agent of disease was recognized appropriately as Plasmodium vivax and treated accordingly.

Ali, Mahdavi Seif; Ahmad, Raeesi; Leyla, Faraji; Reza, Youssefi Mohammad; Taghi, Rahimi Mohammad

2013-01-01

29

Pilomatricoma in children: common but often misdiagnosed.  

PubMed

A pilomatricoma, also known as pilomatrixoma or calcifying epithelioma of Malherbe, is a benign skin tumor arising from the hair follicle matrix. This tumor is common in children and young adults, especially in the head and neck region. However, pilomatricomas are frequently misdiagnosed or not recognized. The history is typical of a slowly enlarging mass, irregularly contoured, it is fixed to the skin but slides freely over the, underlying tissues, often with a discolouration which varies from red to purple-bluish. Ultrasound examination, MRI-scan and fine-needle aspiration can be helpful if the diagnosis is uncertain. Spontaneous regression has never been observed and malignant degeneration is very rare. Surgical excision with clear margins is the treatment of choice, otherwise recurrence may occur due to incomplete resection. PMID:20514848

Roche, N A; Monstrey, S J; Matton, G E

2010-01-01

30

Vulvar intraepithelial neoplasia and microinvasive carcinoma of the vulva  

Microsoft Academic Search

The pathological, cytological, and clinical features of vulvar intraepithelial neoplasia (VIN) are described. The rate of progression of VIN III to an invasive carcinoma is very low and spontaneous regression can occur. These features prevent the drawing of a direct analogy between vulvar and cervical intraepithelial neoplasia. The concept of microinvasive carcinoma of the vulva is discussed, and it is

C H Buckley; E B Butler; H Fox

1984-01-01

31

Reactive fibroblastic and myofibroblastic proliferation of the vulva (Cyclist's Nodule): A hitherto poorly described vulval lesion occurring in cyclists.  

PubMed

Perineal nodules occurring in male cyclists are reported in the literature, although the histologic features are not extensively documented. There has been little description of similar lesions in the female population. We describe 4 cases in which a vulval nodule or swelling developed in competitive female cyclists aged 15 to 45 years. The lesions were unilateral and occurred on the right or left labium majus (2 cases each). The histologic features were similar in all cases and consisted of a haphazard admixture of adipose tissue, variably cellular hyalinized tissue containing bland spindle-shaped fibroblasts, blood vessels, and nerve fibers. In some areas, thick cords of fibrous tissue imparted a keloid-like appearance. Other histologic features included plump mesenchymal cells with round or ovoid nuclei and abundant eosinophilic cytoplasm resulting in an epithelioid, plasmacytoid, or ganglion-like appearance (2 cases), a lymphocytic infiltrate around blood vessels (3 cases), foci of fat necrosis (1 case), and collections of elastic fibers (2 cases). One case recurred, the histologic features of the recurrent lesion being identical to the original. The overall morphologic appearances, especially in the cases with plump mesenchymal cells, bore some resemblance to proliferative fasciitis. Immunohistochemically, the cells were estrogen receptor positive and the plump mesenchymal cells were smooth muscle actin positive, in keeping with myofibroblasts. Desmin, S100, CD34, and HMGA2 were negative. Pathologists should be aware of this pseudoneoplastic lesion occurring on the vulva, which arises in a specific clinical setting and has the potential to be misdiagnosed as a variety of other mesenchymal lesions. We term this lesion as reactive fibroblastic and myofibroblastic proliferation of the vulva or "cyclist's nodule." PMID:21164294

McCluggage, W Glenn; Smith, John H F

2011-01-01

32

Misdiagnoses Common Among U.S. Outpatients: Review  

MedlinePLUS

... please enable JavaScript. Misdiagnoses Common Among U.S. Outpatients: Review 5 percent of adults are affected each year, ... in the journal BMJ Quality Safety . The researchers' review of the published studies involving U.S. adults showed ...

33

[Analysis of a case with Brucellosis misdiagnosed as osteoarthrosis].  

PubMed

Brucellosis is far more frequent in a pasturing area in the northern part of our country and it has many clinical manifestations. It may cause multiple organ damage and its features lack specificity. It is rare in the south, so it is extremely easy to be misdiagnosed or overlooked. The retrospective analysis of a case with Brucellosis misdiagnosed as osteoarthrosis provides a guide for clinical doctors to understand Brucellosis, so that early diagnosis would be accessible, and prognosis could be improved. PMID:24608396

Lai, Liying; Yao, Dongmei

2014-02-01

34

Huge filarial elephantiasis vulvae in a Nigerian woman with subfertility.  

PubMed

Filariasis is a helminthic infection caused by tissue nematodes. It is estimated that at least 120 million people are infected worldwide and another 1 billion are "at risk" of infection. The prevalence is increasing due to uncontrolled urbanization in many of the endemic countries. The geographical distribution is determined mainly by climate and the distribution of the mosquito vector. We report a case of huge filarial elephantiasis of the vulva, in a 40-year-old multipara with background history of secondary infertility. She had excision of the elephantoid vulva lesion under general anaesthesia. A nontender irreducible pedunculated mass (25 cmx21 cm) with a large stalk arising from the right groin down to the ipsilateral labia majora was removed. A similar mass on the left groin, measuring 10 cmx6 cm was removed. Diagnosis was confirmed at histopathologic analysis of the excised masses. Patient was placed on diethyl carbamazine. PMID:18368416

Adesiyun, Adebiyi Gbadebo; Samaila, Modupeola Omotara

2008-12-01

35

Management of radionecrosis of the vulva and distal vagina  

SciTech Connect

Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. (Univ. of South Florida, Tampa (USA))

1991-05-01

36

Primary Breast Adenocarcinoma in Ectopic Breast Tissue in the Vulva  

PubMed Central

Introduction. Accessory breast tissue is a rare finding in the general population with an incidence of 1-2%. An even rarer occurrence is accessory breast tissue afflicted with breast carcinoma. We present a brief report discussing diagnosis and management of a patient who presented with primary breast adenocarcinoma in vulval supranumerary tissue. Brief Report. A 60-year-old Caucasian female presented with a lesion in her left vulva that she first identified during adolescence. The lesion began to grow and ulcerate prompting her to receive treatment. Biopsy was inconclusive, and metastatic workup was negative, so her lesion was treated as an isolated breast lump and removed via wide local excision. Conclusion. Primary breast adenocarcinoma of the vulva is exceedingly rare. A paucity of the literature on this topic unfortunately means that strong evidence does not exist detailing the best management of this patient cohort. However, given that histological data confirms these cancers are virtually the same as breast cancers, it logically follows that the best treatment practices for breast cancer may be applied to treat these patients presenting with primary vulva cancers of ectopic breast tissue.

McMaster, Jason; Dua, Anahita; Dowdy, Sean C.

2013-01-01

37

Primitive neuroectodermal tumor originating in the vulva: A case report  

PubMed Central

Primitive neuroectodermal tumors (PNETs) exhibit chromosomal translocations in common with those of Ewing’s sarcoma. They usually originate in bone or soft tissue but rarely arise in the vulva. The current case report presents a case of PNET originating in the vulva in a 60-year-old female, who previously underwent enucleation of a vulvar tumor in another hospital. The pathologist suspected a histopathological diagnosis of PNET, and simple vulvectomy and resection of the inguinal lymph nodes were performed. An ~3 cm mass recurred in the right side of the vulva four years following the initial surgery and the tumor was excised. The tumor comprised small, round-to-oval nuclei and stained positively for MIC-2, synaptophysin, neuron-specific enolase and neurofilament antibodies. To date, the patient remains alive and with no evidence of disease four years following multidisciplinary treatment, despite PNETs usually exhibiting a poor prognosis. This is due to the small tumor size and the absence of distant metastasis.

MATSUDA, MAKIKO; ICHIMURA, TOMOYUKI; KASAI, MARI; MURAKAMI, MAKOTO; HOSHI, MANABU; KAWAMURA, NAOKI; SUMI, TOSHIYUKI

2014-01-01

38

Non-neoplastic epithelial disorders of the vulva.  

PubMed

Lichen sclerosus, lichen planus, and lichen simplex chronicus are three of the most common non-neoplastic epithelial disorders of the vulva. Lichen sclerosus is characterized by intense vulvar itching and can affect men and women of all ages, but it manifests most commonly in postmenopausal women. Patients with lichen sclerosus have an increased risk of developing squamous cell carcinoma, and they should be monitored for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and the vagina; it peaks in incidence between ages 30 and 60. There are three clinical variants of lichen planus affecting the vulva: erosive, papulosquamous, and hypertrophic. Lichen simplex chronicus is caused by persistent itching and scratching of the vulvar skin, which results in a thickened, leathery appearance. It is thought to be an atopic disorder in many cases and may arise in normal skin as a result of psychological stress or environmental factors. Definitive diagnosis of non-neoplastic disorders depends on the histology of biopsied tissue. All three disorders are treated with topical corticosteroid ointments of varying potency. Lichen sclerosus and lichen planus are not routinely treated with surgery, which is necessary only in patients who have a malignancy or advanced scarring that causes dyspareunia or clitoral phimosis. Educational counseling teaches patients that even though these chronic disorders cannot be cured, they can be effectively managed. PMID:18297956

O'Connell, Theodore Xavier; Nathan, Leena Shankar; Satmary, Wendy Ann; Goldstein, Andrew T

2008-02-01

39

Idiopathic pleuroparenchymal fibroelastosis: an unrecognized or misdiagnosed entity?  

Microsoft Academic Search

Idiopathic pleuroparenchymal fibroelastosis is a rare recently described entity likely to be under- and misdiagnosed, as awareness of this entity is not yet widespread. We report two cases that show the need to include this disease in the differential diagnosis of patients with predominantly pleural and subpleural fibrotic processes. The condition is a fibrotic thickening of the pleura and subpleural

Christian D Becker; Joan Gil; Maria L Padilla

2008-01-01

40

Syringocysadenoma papilliferum of the vulva: a rarity in gynaecology.  

PubMed

A case of syringocystadenoma papilliferum of the vulva in a 36-year-old woman is reported .The patient presented with a single cystic lesion on the left labia minora of 8?years duration with a recent increase in size and redness around the lesion. Examination revealed a polypoid cystic lesion with no regional lymphadenopathy. An excision biopsy was performed under general anaesthesia and the specimen was subjected to histological examination. Histopathology revealed closely excised syringocystadenoma papilliferum. On follow-up, the patient was asymptomatic and the wound had healed well. PMID:24872485

Steshenko, Oleksandr; Chandrasekaran, Nirmala; Lawton, Frank

2014-01-01

41

Photodynamic Therapy for Bowen's Disease of the Vulva Area  

PubMed Central

Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm2 for a dose of 120 J/cm2 biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area.

Kang, Hong-Kyu; Yun, Jeong-Hwan; Son, Young-Min; Roh, Joo-Young

2014-01-01

42

Photodynamic Therapy for Bowen's Disease of the Vulva Area.  

PubMed

Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm(2) for a dose of 120 J/cm(2) biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area. PMID:24882981

Kang, Hong-Kyu; Yun, Jeong-Hwan; Son, Young-Min; Roh, Joo-Young; Lee, Jong-Rok

2014-04-01

43

External ophthalmomyiasis caused by Oestrus ovis misdiagnosed as bacterial conjunctivitis.  

PubMed

Ophthalmomyiasis is the infestation of the eye by maggots or bots of certain flies which is mostly caused by Oestrus ovis. The most common form of ophthalmomyiasis is external that only the external surface of the eye is involved. Symptoms of external myiasis are nonspecific so it can be misdiagnosed as any other conjunctivitis if the doctors do not take myiasis into consideration. We report a case series of external ophthalmomyiasis. All the patients complained of mild foreign body sensation, redness, watery eyes and some of them had lid swelling. Larvae on the external surface of the patients must be removed under dim light. Larvae can hide in the fornices of the patients as happened in our two cases. Because of our lack of experience about ophthalmomyiasis, we misdiagnosed the first patient as bacterial conjunctivitis. Ophthalmomyiasis may be difficult to detect so ophthalmologists must keep in mind the possibility of ophthalmic myiasis especially in rural regions. PMID:23780871

Akdemir, Mehmet O; Ozen, Serkan

2013-07-01

44

Emergency laparotomy for misdiagnosed biliary cystadenoma originating from caudate lobe  

PubMed Central

Background Biliary cystadenoma is a rare benign neoplasm, which is often misdiagnosed for a hepatic abscess or a hydatid cyst that tends to recur and is at risk for progression to malignant neoplasm. Case presentation This case describes a 30-year-old woman admitted to our institution in an emergency setting. The patient was originally misdiagnosed as affected by a hepatic hydatid cyst at another hospital, and then emergently treated at our Institution for severe abdominal pain. Histologic evaluation of the cyst showed that it was a biliary cystadenoma and, therefore, the patient underwent a hepatic resection in order to completely remove the lesion. Conclusion Complete excision of any suspicious hepatic cystic lesion remains the best method for diagnosis and treatment of cystadenoma. Incomplete excision of most biliary cystadenoma results in a higher rate of recurrence and the risk of malignant transformation. We report this case to elucidate the clinical presentation, preoperative evaluation, and surgical treatment of these rare lesions.

Ramacciato, Giovanni; Nigri, Giuseppe R; D'Angelo, Francesco; Aurello, Paolo; Bellagamba, Riccardo; Colarossi, Cristina; Pilozzi, Emanuela; Del Gaudio, Massimo

2006-01-01

45

Protruding vulva mutants identify novel loci and Wnt signaling factors that function during Caenorhabditis elegans vulva development.  

PubMed Central

The Caenorhabditis elegans vulva develops from the progeny of three vulval precursor cells (VPCs) induced to divide and differentiate by a signal from the somatic gonad. Evolutionarily conserved Ras and Notch extracellular signaling pathways are known to function during this process. To identify novel loci acting in vulval development, we carried out a genetic screen for mutants having a protruding-vulva (Pvl) mutant phenotype. Here we report the initial genetic characterization of several novel loci: bar-1, pvl-4, pvl-5, and pvl-6. In addition, on the basis of their Pvl phenotypes, we show that the previously identified genes lin-26, mom-3/mig-14, egl-18, and sem-4 also function during vulval development. Our characterization indicates that (1) pvl-4 and pvl-5 are required for generation/survival of the VPCs; (2) bar-1, mom-3/mig-14, egl-18, and sem-4 play a role in VPC fate specification; (3) lin-26 is required for proper VPC fate execution; and (4) pvl-6 acts during vulval morphogenesis. In addition, two of these genes, bar-1 and mom-3/mig-14, are known to function in processes regulated by Wnt signaling, suggesting that a Wnt signaling pathway is acting during vulval development.

Eisenmann, D M; Kim, S K

2000-01-01

46

A Case of Dowling-Degos Disease on the Vulva  

PubMed Central

Dowling-Degos disease (DDD) is an autosomal dominant genodermatosis and this disease is a genetically determined disturbance of epidermal proliferation. It is characterized by acquired, slowly progressive pigmented lesions that primarily involve the great skin folds and flexural areas such as the axilla, neck, limb flexures, the inframammary area and the inguinal folds. The vulva is an unusual location for DDD. A 41-year-old woman presented with a 10-year history of multiple, small, reticulated and brownish macules distributed symmetrically on the bilateral external genital regions. We found no other similarly pigmented skin lesions on her body, including the flexural areas. There was no known family history of similar eruptions or pigmentary changes. The histologic examination showed irregular rete ridge elongation with a filiform or antler-like pattern and basilar hyperpigmentation on the tips. Fontana-Masson staining showed increased pigmentation of the rete ridges and the S100 protein staining did not reveal an increased number of melanocytes in the epidermis. From these findings, we diagnosed this lesion as DDD.

Kang, Ho Song; Hur, Jae; Lee, Jung Woo; Oh, Dae Heon; Yeo, Kwang Yeoll; Kim, Joung Soo

2011-01-01

47

Uncommon congenital antral web misdiagnosed twice as a pyloric ulcer: successful treatment with endoscopic balloon dilatation.  

PubMed

Congenital antral webs are quite rare and easily overlooked or misdiagnosed. We report the case of a five-year-old boy who presented with symptoms of gastric outlet obstruction for four years; his condition was misdiagnosed twice as pyloric ulcer. Detailed gastroscopy revealed a congenital antral web. The stricture was successfully treated with endoscopic balloon dilatation without surgery. PMID:24827957

Lu, Jung Ping; Huang, Ying; Wu, Jie; Chen, Shi Yao

2014-01-01

48

Cryptic variation in vulva development by cis-regulatory evolution of a HAIRY-binding site.  

PubMed

Robustness to mutations is a general principle of biological systems that allows for the accumulation of cryptic variation. However, little is known about robustness and cryptic variation in core developmental pathways. Here we show through gonad-ablation screens in natural isolates of Pristionchus pacificus cryptic variation in nematode vulva development. This variation is mainly caused by cis-regulatory evolution in the conserved Notch ligand apx-1/Delta and involves binding sites for the transcription factor HAIRY. In some isolates, including a Bolivian strain, absence of a HAIRY-binding site results in Ppa-apx-1 expression in the vulva precursor cell P6.p and causes gonad-independent vulva differentiation. In contrast, a Californian strain that gained a HAIRY-binding site lacks Ppa-apx-1 vulval expression and shows gonad-dependence of vulva development. Addition of this HAIRY-binding site to the Bolivian Ppa-apx-1 promoter eliminates expression in the vulva. Our findings indicate significant cis-regulatory evolution in a core developmental pathway leading to intraspecific cryptic variation. PMID:23591881

Kienle, Simone; Sommer, Ralf J

2013-01-01

49

Lumbar hernia misdiagnosed as a subcutaneous lipoma: a case report  

PubMed Central

Introduction Lumbar hernia is a rare abdominal wall defect and clinical suspicion is necessary for diagnosis. Case presentation We report the case of a 40-year-old Caucasian woman with a superior lumbar hernia (Grynfeltt hernia) initially misdiagnosed as a recurrent lipoma. The correct diagnosis was made intra-operatively and the hernia was repaired using synthetic mesh. The patient was free of recurrence at 4 months after the operation. Conclusion A lumbar or flank mass should always raise suspicion of a lumbar hernia. Ultrasound and computed tomography may confirm the diagnosis. Adequate surgical treatment should be planned on the basis of etiology and hernia size. Both open and laparoscopic techniques can be used with good results.

2009-01-01

50

Is hyperthyroidism underestimated in pregnancy and misdiagnosed as hyperemesis gravidarum?  

PubMed

Thyroid changes are considered to be normal events that happen as a large maternal multiorganic adjustment to pregnancy. However, hyperthyroidism occurs in pregnancy with clinical presentation similar to hyperemesis gravidarum (HG) and pregnancy itself. Moreover, 10% of women with HG will continue to have symptoms throughout the pregnancy suggesting that the underlying cause might not be elevation of human chorionic gonadotropin in the first trimester. Variable frequency of both hyperthyroidism and HG worldwide might suggest the puzzlement of inclusion criteria for both diagnoses enhanced by the alternation of thyroid hormone levels assessed in normal pregnancy. Increased number of hyperthyroidism among women population without the expected rise in gestational hyperthyroidism encouraged us for creating the hypotheses that hyperthyroidism could be underestimated in normal pregnancy and even misdiagnosed as HG. This hypothesis, if confirmed, might have beneficial clinical implications, such as better detection of hyperthyroidism in pregnancies, application of therapy when needed with the reduction of maternal or fetal consequences. PMID:20471758

Luetic, Ana Tikvica; Miskovic, Berivoj

2010-10-01

51

Keratocystic odontogenic tumour (KCOT) misdiagnosed as a dentigerous cyst.  

PubMed

Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40 years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed. PMID:23429028

Chaudhary, Seema; Sinha, Ashish; Barua, Pranamee; Mallikarjuna, Rachappa

2013-01-01

52

Idiopathic pleuroparenchymal fibroelastosis: an unrecognized or misdiagnosed entity?  

PubMed

Idiopathic pleuroparenchymal fibroelastosis is a rare recently described entity likely to be under- and misdiagnosed, as awareness of this entity is not yet widespread. We report two cases that show the need to include this disease in the differential diagnosis of patients with predominantly pleural and subpleural fibrotic processes. The condition is a fibrotic thickening of the pleura and subpleural parenchyma due to elastic fiber proliferation predominantly in the upper lobes. Performing elastic fiber stains routinely in patients with fibrosis of this distribution may, therefore, aid in establishing the diagnosis and differentiating it from usual interstitial pneumonia/idiopathic pulmonary fibrosis. These patients may be prone to the development of secondary spontaneous pneumothoraces and persistent postoperative bronchopleural fistulae. Continued study of newly diagnosed cases may uncover shared characteristics or features helpful in generating an etiologic hypothesis. Only with better understanding of this disease can we hope in the future to be able to offer treatments other than supportive care and ultimately lung transplantation, which are the only therapeutic options available today. PMID:18408658

Becker, Christian D; Gil, Joan; Padilla, Maria L

2008-06-01

53

[Two stiff person cases misdiagnosed as conversion disorder].  

PubMed

Modern psychiatric diagnostic systems classify neurological symptoms that cannot be explained by a physical disease or another psychiatric disorder as conversion disorder (CD) or dissociative motor disorder. It is a well-known fact that the overall rate of misdiagnosis of conversion symptoms is high. The most common presenting symptoms of misdiagnosed patients are gait and movement disturbances. Stiff-person syndrome (SPS) is a rare progressive autoimmune neurological disorder. The identification of antibodies against glutamic acid decarboxylase (GAD) in association with SPS provided an important contribution to the understanding of the pathophysiology of this syndrome. Patients may present with severe muscle rigidity and sudden contractions. Simultaneous contraction of agonist and antagonist muscles produces gait disturbance. SPS can be exacerbated by emotional stressors, and sudden auditory, visual, and tactile stimuli. Herein we present 2 patients that were referred for psychiatric assessment, because their neurological symptoms initially could not be explained by a neurological disease, and subsequently diagnosed as SPS. The aim of this case report is to draw attention to the psychiatric presentations of SPS and to emphasize the importance of complete psychiatric and neurological examination, including brain imaging and electrophysiological studies, in the differential diagnosis of CD. PMID:20013431

Ozer, Suzan; Ozcan, Halil; Dinç, Gülser Senses; Ertu?rul, Aygün; Rezaki, Murat; Ulu?ahin, Aylin

2009-01-01

54

Trends in Squamous Cell Carcinoma of the Vulva: The Influence of Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Objective: To determine trends in the clinicopathology of vulvar squamous cell carcinoma over the past 2 decades, with particular reference to the possible effects of the increasing incidence of vulvar intraepithelial neoplasia (VIN) during this time.Methods: Two cohorts of 56 and 57 women with squamous cell carcinoma of the vulva and separated by at least 2 decades were reviewed retrospectively.

R. W Jones; Judith Baranyai; S Stables

1997-01-01

55

Diagnosis of Primary Langerhans Cell Histiocytosis of the Vulva in a Postmenopausal Woman  

PubMed Central

Langerhans cell histiocytosis (LCH) is a very rare disease of female genital tract, most commonly seen in vulva and unusual in postmenopausal period. Herein, we report the 8th case of pure vulvar LCH in a postmenopausal woman. We pay attention to the differential diagnosis in postmenopausal state, features of pathologic diagnosis, and treatment options.

Kurt, Sefa; Kopuz, Aycan; Solakoglu Kahraman, Dudu; Tasyurt, Abdullah

2013-01-01

56

Primary Breast Carcinoma of the Vulva: A Case Report and Review of the Literature  

Microsoft Academic Search

We present a case of primary carcinoma of the vulva successfully treated with local excision and ipsilateral groin dissection. Eleven cases of this entity have been reported in the world literature since 1936. We review the literature and offer guidelines regarding morphologic and immunohistochemical criteria for diagnosis and primary and adjuvant treatment for this rare condition.

M. Levin; R. M. Pakarakas; H. A. Chang; M. Maiman; S. L. Goldberg

1995-01-01

57

Evolution of regulatory networks: nematode vulva induction as an example of developmental systems drift.  

PubMed

Changes in the developmental processes and developmental mechanisms can result in the modification of morphological structures and in the evolution of phenotypic novelty. But how do developmental processes evolve? One striking finding in modern biology is the confrontation of morphological diversity in multicellular organisms with the conserved blueprint of life-the small number of conserved signaling pathways and transcriptional regulators. Evolutionary developmental biology (evo-devo) tries to explain this discrepancy between macroscopic diversity and molecular uniformity. Selected case studies in evo-devo models allowed detailed insight into the mechanisms of evolutionary changes and might help solving this problem. Here, I compare the formation of vulva development between Caenorhabditis elegans and the evo-devo model Pristionchus pacificus. More than 3 decades of work in C. elegans and 15 years in P. pacificus provide an insight into the molecular mechanisms of developmental change during vulva evolution. C. elegans and P. pacificus differ first, in the type of the signaling system used for vulva induction; second, the cells required for the inductive interactions; third, the logic of the signal system, and finally, the sequence and structure of peptide domains in otherwise conserved proteins. Nonetheless, the vulva is formed from the same three cells in both nematodes. I discuss redundancy as an evolutionary mechanism to explain developmental systems drift, a theory predicting conserved morphological structures to be generated by diverse molecular regulatory networks. PMID:22821454

Sommer, Ralf J

2012-01-01

58

Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical-radiologic-pathologic correlations.  

PubMed

Purpose: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. Materials and methods: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9-32 years (mean age 15.9 years). Results: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. Conclusion: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of TOS, and these features are helpful in making the correct preoperative diagnosis of TOS. PMID:24334494

Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei; Li, Jia-Ping

2013-01-01

59

let-60, a Gene That Specifies Cell Fates during C. elegans Vulva1 Induction, Encodes a MS Protein  

Microsoft Academic Search

Summary Genetic analysis previously suggested that the 181-60 gene controls the switch between vulva1 and hypoder- mal cell fates during C. elegans vulva1 induction. We have cloned the let-60 gene, and shown that it en- codes a gene product ldentlcal in 84% of its first 164 amino acids to ras gene products from other ver- tebrate and invertebrate species. This

Min Han; Paul W. Sternberg

60

Proximal-type epithelioid sarcoma of the vulva with INI1 diagnostic utility  

Microsoft Academic Search

Proximal epithelioid sarcoma (PES) is an extremely uncommon neoplasm of the vulva with an aggressive behavior. Recently, these authors experienced a case of proximal-type ES in a 41-year-old woman who was admitted for a rapidly growing mass in the right mons pubis. An about-1-cm-sized mass was initially noticed one and a half years earlier. The excised mass, however, was 8

Hyun-Jung Kim; Myoung-Hwan Kim; Jieun Kwon; Jung Yeon Kim; Jae Y. Ro

61

Squamous cell carcinoma of the vulva in a virgin patient with Turner syndrome.  

PubMed

Two types of gynecologic tumors are commonly described in the Turner syndrome, the first one is gonadoblastoma, which occurs in patients with Y chromosome abnormalities, and the second one is endometrial carcinoma which is mostly related with exogenous estrogen usage. Here, we describe an extremely rare case of squamous cell carcinoma of the vulva in a virgin woman with Turner syndrome. A 35-years old single, virgin woman referred to our Oncology Department with warty, necrotized, exophytic 6-7 cm vulvar mass. She had a history of primary amenorrhea and mosaic Turner syndrome was determined in her karyotype analysis. Biopsy specimen of the vulvar mass revealed squamous cell carcinoma of the vulva, and total vulvectomy with inguinal femoral lymphadenectomy was performed. The postoperative course was uneventful and there has been no recurrence of the disease up to date. Women with Turner syndrome have streak ovaries that produce very low estrogen and the squamous cell carcinoma of the vulva may have developed at an early age with Turner syndrome because of this low estrogen value similar to postmenopausal women. The current case is a special case due to its age of occurrence, virgin and Turner syndrome status. PMID:21998766

Tapisiz, Omer Lutfi; Topcu, Onur; Gungor, Tayfun; Ozdal, Bulent; Sirvan, Levent; Yesilyurt, Ahmet

2011-09-01

62

Squamous cell carcinoma of the vulva in a virgin patient with Turner syndrome  

PubMed Central

Two types of gynecologic tumors are commonly described in the Turner syndrome, the first one is gonadoblastoma, which occurs in patients with Y chromosome abnormalities, and the second one is endometrial carcinoma which is mostly related with exogenous estrogen usage. Here, we describe an extremely rare case of squamous cell carcinoma of the vulva in a virgin woman with Turner syndrome. A 35-years old single, virgin woman referred to our Oncology Department with warty, necrotized, exophytic 6-7 cm vulvar mass. She had a history of primary amenorrhea and mosaic Turner syndrome was determined in her karyotype analysis. Biopsy specimen of the vulvar mass revealed squamous cell carcinoma of the vulva, and total vulvectomy with inguinal femoral lymphadenectomy was performed. The postoperative course was uneventful and there has been no recurrence of the disease up to date. Women with Turner syndrome have streak ovaries that produce very low estrogen and the squamous cell carcinoma of the vulva may have developed at an early age with Turner syndrome because of this low estrogen value similar to postmenopausal women. The current case is a special case due to its age of occurrence, virgin and Turner syndrome status.

Topcu, Onur; Gungor, Tayfun; Ozdal, Bulent; Sirvan, Levent; Yesilyurt, Ahmet

2011-01-01

63

Two cases of tracheal disease misdiagnosed as difficult-to-treat asthma.  

PubMed

Initial management of patients with difficult-to-treat asthma must begin with confirmation of the diagnosis. We present 2 cases of tracheal disease misdiagnosed as difficult-to-treat asthma. After systemic evaluation, tracheomalacia and tracheobronchial narrowing due to diffuse calcification of the cartilaginous rings were found as mimicking asthma. PMID:23431310

Alici, Ibrahim Onur; Kar Kurt, Ozlem; Dursun, Adile Berna; Yilmaz, Aydin; Erkekol, Ferda Oner

2013-11-01

64

Adenocarcinoma de colo uterino com disseminação linfática apresentando-se como carcinoma en cuirasse da vulva: relato de caso.  

PubMed

We report the case of a patient with carcinoma "en cuirasse" of the vulva. Case report: A female patient presented complaining of inguinal lymphadenopathy. Lymph node excision, immunohistochemistry analyses, and further exams showed the presence of cervical adenocarcinoma. The cancer was surgically removed and the patient was treated with radiotherapy and chemotherapy with a good initial response. Some months later she presented with intense edema of the lower limbs, hardening and thickening of the labia majora, and pelvic and genital ulceration. A cutaneous biopsy with subsequent immunohistochemical staining showed lymphatic dissemination of adenocarcinoma to the vulva. Discussion: Carcinoma "en cuirasse" is a rare presentation of cutaneous metastasis in which the affected skin shows hardening and induration, acquiring a sclerodermoid appearance. This is, to the best of our knowledge, the first report in Brazil of carcinoma "en cuirasse" of the vulva associated with cervical adenocarcinoma. PMID:24852775

Silva de Lima, Adma; Casemiro, Karla Patricia; Rovere, Rodrigo Kraft

2014-01-01

65

Accuracy of preoperative vulva biopsy and the outcome of surgery in vulvar intraepithelial neoplasia 2 and 3.  

PubMed

To assess the accuracy of preoperative vulva biopsy and the outcome of surgery in vulvar intraepithelial neoplasia (VIN) 2 and 3. In this study 186 consecutive patients with VIN 2 and 3, who were treated with local wide excision or skinning vulvectomy at the Department of Obstetrics and Gynecology, Medical University of Vienna, between 1996 and 2008, were enrolled. Accuracy of preoperative vulva biopsy was assessed by evaluating the rates of correct diagnosis, underdiagnosis, and occult cancer. Histologic findings of preoperative vulva biopsy and surgery were compared. To assess risk factors for incomplete resection, univariate and multivariate analyses were performed, by using the presence of multifocal VIN, histologic grade, patients' age, surgeons' expertise, and lesion diameter as independent variables. VIN 2 and 3 were correctly diagnosed by preoperative vulva biopsy in 55.8% (29/52) and 88.1% (118/134) patients, respectively. Underdiagnosis occurred in 44.2% (23/52) and 11.9% (16/134) of preoperative vulva biopsies with an occult cancer rate of 3.8% (2/52) and 11.9% (16/134) for VIN 2 and 3, respectively. Complete resection was achieved in 43.0% (80/186) of patients. Presence of multifocal VIN was the only factor that was associated with incomplete resection in our study population in univariate and multivariate analyses (P=0.001, P=0.001). Mean patients' age at the time of diagnosis was 51.1 (SD: 15.7) years, multifocal lesions were present in 36.0% (67/186), and the median lesion diameter was 15.0 mm (interquartile range: 10.0-30.0). A significant number of VIN 2 and 3 were underdiagnosed by preoperative vulva biopsy. The rate of incomplete resection after surgery is notable. PMID:19851204

Polterauer, Stephan; Catharina Dressler, Anne; Grimm, Christoph; Seebacher, Veronika; Tempfer, Clemens; Reinthaller, Alexander; Hefler, Lukas

2009-11-01

66

Prognostic analysis of early-stage squamous cell carcinoma of the vulva  

PubMed Central

Aim The aim of this study was to analyze prognostic factors of early-stage squamous cell carcinoma of the vulva. Methods A retrospective analysis was conducted on 35 patients who were treated for early-stage squamous cell carcinoma of the vulva at Sun Yat-sen University Cancer Center from January 1980 to December 2005. The Statistical Package for Social Science (SPSS) was used to compare the different strategies of operation and to analyze the prognostic factors. Results Thirty-five patients had early-stage squamous cell carcinoma of the vulva. Of these cases, 26 were well differentiated, seven were moderately differentiated, and two were poorly differentiated. The five-year survival rate was 77.1%. Five cases were in FIGO stage 1a and 30 cases were in stage 1b; median survival times were 182.3 months and 152.5 months, and the five-year survival rates were 100% and 81.5% (P >0.05), respectively. The five-year survival of the patients who underwent local excision; radical vulvectomy and en bloc resection of inguinofemoral lymphadenectomy; orradical vulvectomyen bloc resection of inguinofemoral lymphadenectomy, and pelvic lymph nodes was 50%, 81.8%, and 83.9%, respectively. For these cases, 74.3% of the tumors were medial while 25.7% were lateral, and the five-year survival rates of patients according to tumor location were 87.0% and 64.8% (P <0.05), respectively. The inguinal lymph node not increased and active were 16 cases (45.7%), and increased, active and hard were 17 cases (48.6%), and syncretic were two cases (5.7%), five-year survival rates were 73.3%, 92.9% and 50% (P <0.05), respectively. Of these cases, 74.3% of the tumors were cauliflower-like and 25.7% were nodular; five-year survival rates by tumor type were 91.3% and 66.7% (P <0.05), respectively. Conclusions For patients with early-stage squamous cell carcinoma of the vulva, surgical operation is the primary, yet the best, treatment. The related prognostic factors were tumor location (lateral/medial), stage, gross morphology, and clinical state of the inguinal lymph node.

2013-01-01

67

Decreased antioxidant enzyme expression and increased oxidative damage in erosive lichen planus of the vulva.  

PubMed

The aim of this study was to investigate whether increased oxidative stress occurs in erosive lichen planus of the vulva. Skin biopsies from six patients with untreated, histologically confirmed erosive lichen planus of the vulva were examined immunohistochemically using antibodies against antioxidant enzymes. The protein-bound lipid peroxidation products malondialdehyde (MDA) and 4-hydroxynonenale (4-HNE) and the oxidative DNA damage marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) were investigated. Protein carbonyls as markers of protein oxidation were visualised using the dinitrophenylhydrazone (DNPH) method. Normal vulval tissues from 12 subjects served as controls. In vulval lichen planus tissue the enzymatic antioxidant defence was found to be significantly decreased in the epidermal layers. Furthermore, a significant increase of lipid peroxidation products and oxidative DNA damage was found within the epidermis. Protein oxidation occurred predominantly in the papillary dermis. This is the first study to demonstrate a decreased antioxidant defence and increased oxidative damage to lipids, DNA and proteins in lichen planus. These oxidative modifications point to pathophysiological alterations mainly within the basal cell layers of the epidermis and at the dermoepidermal junction. Further studies are warranted to investigate the potential role of oxidative stress in the development of autoimmunity in this disease. PMID:16225582

Sander, C S; Cooper, S M; Ali, I; Dean, D; Thiele, J J; Wojnarowska, F

2005-11-01

68

The Caenorhabditis elegans vulva: A post-embryonic gene regulatory network controlling organogenesis  

PubMed Central

The Caenorhabditis elegans vulva is an elegant model for dissecting a gene regulatory network (GRN) that directs postembryonic organogenesis. The mature vulva comprises seven cell types (vulA, vulB1, vulB2, vulC, vulD, vulE, and vulF), each with its own unique pattern of spatial and temporal gene expression. The mechanisms that specify these cell types in a precise spatial pattern are not well understood. Using reverse genetic screens, we identified novel components of the vulval GRN, including nhr-113 in vulA. Several transcription factors (lin-11, lin-29, cog-1, egl-38, and nhr-67) interact with each other and act in concert to regulate target gene expression in the diverse vulval cell types. For example, egl-38 (Pax2/5/8) stabilizes the vulF fate by positively regulating vulF characteristics and by inhibiting characteristics associated with the neighboring vulE cells. nhr-67 and egl-38 regulate cog-1, helping restrict its expression to vulE. Computational approaches have been successfully used to identify functional cis-regulatory motifs in the zmp-1 (zinc metalloproteinase) promoter. These results provide an overview of the regulatory network architecture for each vulval cell type.

Ririe, Ted O.; Fernandes, Jolene S.; Sternberg, Paul W.

2008-01-01

69

[Pathomorphology of human papillomavirus (HPV) infection of the cervix uteri and vulva].  

PubMed

An infection with Human Papilloma Virus (HPV) is directly associated with the development of the cervical and vulvar carcinomas. The infection should be diagnosed and considered in the choice of therapy. Taking no account of HPV infection in histological pictures may lead to overdiagnosis of Ca"0" (CIS). HPV infection is possible to be recognized--in most cases--in cytological and histopathological studies. Cytological and histopathological studies are the basis for other examination methods. The authors, who have been dealing with HPV problem for 10 years, describe characteristic morphological features of the HPV infection based upon original material accompanied by microscopic documentation. The article describes: the types of condylomas, morphological properties of koilocyte and dyskeratocyte with consideration of electronmicroscopic studies, specific features of the infected epithelium, the notion of koilocytic atypia and atypical condylomas, diagnostic difficulties, differentiation with classic dysplasia, the presence of changes typical for Bowen's disease of the cervix and Bowenoid papulosis on the vulva. Morphological diagnosis of the HPV infection worse--in many cases--confirmed by virusologic studies determining the type of the virus in the tissue. It is the authors' opinion that koilocytic atypia is a special form of the intraepithelial neoplasia (CIN, VIN). They emphasize the contribution of the HPV infection to the prevention of cancer of the uterine cervix and vulva. PMID:1966114

Borowicz, K; Walczak, L

1990-01-01

70

Yolk sac tumor of the vulva: a case report with recurrence after long-term follow-up.  

PubMed

A yolk sac tumor (YST) of the vulva is extremely rare and highly malignant with recurrence frequently occurring within a year. This report presents the 13th known case of vulvar YST, with recurrence occurring after the longest known follow-up period so far reported in the literature. PMID:22868632

Mochizuki, Kyoko; Obatake, Masayuki; Taura, Yasuaki; Inamura, Yukio; Takatsuki, Mitsuhisa; Nagayasu, Takeshi; Eguchi, Susumu

2012-09-01

71

Keratotic horn on left fifth fingertip: congenital ectopic nail misdiagnosed as a common wart.  

PubMed

The term "ectopic nail" refers to nail tissue found in a location other than in the normal nail bed. Here we report a 9-year-old girl with an asymptomatic keratotic "horn" on the tip of her left fifth finger. Present since the age of 1?month, it was misdiagnosed as a common wart and treated using liquid nitrogen cryotherapy without benefit. PMID:22277059

Bilenchi, Roberta; Poggiali, Sara; De Paola, Mariele; Batsikosta, Natasha; Fimiani, Michele

2013-01-01

72

Gastric Duplication Cyst: A Rare Congenital Disease Often Misdiagnosed in Adults  

PubMed Central

Gastrointestinal duplication is a rare congenital disease which affected more commonly the ileum, while the stomach is rarely involved. Generally diagnosed in paediatric or young age, it could be difficult to suspect a gastrointestinal duplication in adults. Herein, we report a 55-year-old male with a gastric duplication cyst found on routinely checkup for chronic hepatitis and first misdiagnosed as a gastrointestinal stromal tumor (GIST); we also discuss its embryology.

Falleti, Jessica; Vigliar, Elena; Zeppa, Pio; Schettino, Pietro; Napolitano, Vincenzo; D'Armiento, Maria

2013-01-01

73

Congenital Anomaly of the Atlas Misdiagnosed as Posterior Arch Fracture of the Atlas and Atlantoaxial Subluxation  

PubMed Central

Partial or complete absence of the posterior arch of the atlas is a well-documented anomaly but a relatively rare condition. This condition is usually asymptomatic so most are diagnosed incidentally. There have been a few documented cases of congenital defects of the posterior arch of the atlas combined with atlantoaxial subluxation. We report a very rare case of congenital anomaly of the atlas combined with atlantoaxial subluxation, that can be misdiagnosed as posterior arch fracture.

Park, Yung; Kim, Seong Min; Lee, Yun Tae; Yoo, Ju Hyung; Oh, Hyun Chul; Sung, Seung Yong; Yoon, Han Kook; Chang, Jee-Hoon; Jung, Jeung-Yeul

2014-01-01

74

Cancer - vulva  

MedlinePLUS

... age 50 History of cervical cancer or vaginal cancer Smoking Women with a condition called vulvar intraepithelial neoplasia (VIN) have a high risk of developing vulvar cancer that spreads. Most cases of VIN, though, never ...

75

Local steroid application for hyperplastic dystrophy of the vulva. Clinical and pathologic evaluation.  

PubMed

Fifteen women complaining of vulvar pruritus of at least three months' duration were evaluated clinically and noted to have white lesions of the vulva consistent with hyperplastic dystrophy. Histologic evaluation confirmed the diagnosis, and all the patients were treated with local application of halocidine cream and crotamiton cream. After six weeks of therapy a repeat clinical and histologic evaluation revealed 13 of the 15 patients to be completely relieved of the vulvar pruritus, and 12 of the 13 were histologically demonstrated to have complete reversal of the hyperplastic process to normal skin. The other two denied any improvement in their pruritus and were histologically noted to have persistence of the hyperplastic process. A good clinical and histologic correlation was noted following local steroid application in patients with histologically proven hyperplastic dystrophy. PMID:3404516

Bergman, A; Karram, M; Bhatia, N N

1988-06-01

76

Clinico-pathological and biological prognostic variables in squamous cell carcinoma of the vulva.  

PubMed

Several clinical-pathological parameters have been related to survival of patients with invasive squamous cell carcinoma of the vulva, whereas few studies have investigated the ability of biological variables to predict the clinical outcome of these patients. The present paper reviews the literature data on the prognostic relevance of lymph node-related parameters, primary tumor-related parameters, FIGO stage, blood variables, and tissue biological variables. Regarding these latter, the paper takes into account the analysis of DNA content, cell cycle-regulatory proteins, apoptosis-related proteins, epidermal growth factor receptor [EGFR], and proteins that are involved in tumor invasiveness, metastasis and angiogenesis. At present, the lymph node status and FIGO stage according to the new 2009 classification system are the main predictors for vulvar squamous cell carcinoma, whereas biological variables do not have yet a clinical relevance and their role is still investigational. PMID:22015047

Gadducci, Angiolo; Tana, Roberta; Barsotti, Cecilia; Guerrieri, Maria Elena; Genazzani, Andrea Riccardo

2012-07-01

77

Erosive lichen planus of the vulva: weak circulating basement membrane zone antibodies are present.  

PubMed

The objective of this study was to investigate whether circulating basement membrane zone (BMZ) antibodies are present in erosive lichen planus (LP) of the vulva. In total, 56 consecutive women with biopsy-confirmed erosive LP of the vulva were recruited from a vulval clinic in a district general hospital and teaching hospital in Oxfordshire. Indirect immunofluorescence (IgG and IgA) was performed on 56 sera, and 15 were tested to IgG subclasses (1-4). Immunoblotting was carried out on salt-split and urea-extracted epidermal skin extracts on 11. The main outcome measure was the presence or absence of staining at the BMZ. Of the 56 sera, 34 (61%) had weak (neat or 1 : 5) epidermal-binding BMZ antibodies (25 had IgG, 5 had IgA, 4 had both IgG and IgA). All 15 sera tested to IgG showed epidermal binding to one or more IgG subclasses: IgG1 (7 sera), IgG2 (7), IgG3 (7) and IgG4 (0). Immunoblotting identified IgG antibodies to bullous pemphigoid (BP)180 (10/11) and BP230 (2/11). The majority (61%) of patients with vulval erosive LP had circulating serum IgG BMZ antibodies, chiefly reacting with BP180. There was subclass restriction of the IgG response to IgG1, 2 and 3. The significance of these antibodies is uncertain, but they may be a marker for the disease. PMID:16045691

Cooper, S M; Dean, D; Allen, J; Kirtschig, G; Wojnarowska, F

2005-09-01

78

Proximal-type epithelioid sarcoma of the vulva with INI1 diagnostic utility.  

PubMed

Proximal epithelioid sarcoma (PES) is an extremely uncommon neoplasm of the vulva with an aggressive behavior. Recently, these authors experienced a case of proximal-type ES in a 41-year-old woman who was admitted for a rapidly growing mass in the right mons pubis. An about-1-cm-sized mass was initially noticed one and a half years earlier. The excised mass, however, was 8 cm in greatest dimension and was relatively well circumscribed. The cut surface was trabeculated, with multifocal hemorrhages and necroses. Microscopically, the tumor consisted of epithelioid rhabdoid cells with vesicular nuclei, large prominent nucleoli, and cytoplasmic eosinophilic globules comparted by thin, fibrous septae. The main differential diagnoses included PES, other sarcomas with epithelioid cells, malignant melanoma, and sarcomatoid carcinoma. The tumor cells were diffusely positive for vimentin and EMA; focally positive for cytokeratin; and negative for CK5/6, CD34, S-100 protein, desmin, and myogenin. INI1 (hSNF5/SMARCB1, a member of the SW1/SNF chromatin remodeling complex located on chromosome 22q11.2) staining clearly showed loss of expression in the tumor cells. Recent studies reported that some ESs also showed INI1 inactivation, as characteristically seen in malignant rhabdoid tumors of infancy. Reported herein is the diagnostic utility of INI-1 on PES and the possible relationship between PES and malignant rhabdoid tumor of the soft tissue, besides a collective review of the reported cases of PES of the vulva and of the current case. PMID:21724432

Kim, Hyun-Jung; Kim, Myoung-Hwan; Kwon, Jieun; Kim, Jung Yeon; Park, Kyeongmee; Ro, Jae Y

2012-10-01

79

Progressive Supranuclear Palsy Misdiagnosed as Parkinson's Disease: A Case Report and Review of Literature  

PubMed Central

Because of its increasingly recognized clinical diversity, progressive supranuclear palsy (PSP) may be difficult to diagnose, particularly in resource-poor settings where the means of getting supportive tests is a huge challenge. This often results in underdiagnosis or misdiagnosis of PSP, most commonly as Parkinson's disease. The author reported a case of how brain magnetic resonance imaging (MRI) was used to arrive at the diagnosis of PSP in a man previously misdiagnosed as Parkinson's disease. Relevant literatures regarding the diagnostic utility of MRI in PSP were also reviewed.

Owolabi, LF

2013-01-01

80

Arteriovenous Fistula of the Filum Terminale Misdiagnosed and Previously Operated as Lower Lumbar Degenerative Disease  

PubMed Central

Filum terminale arteriovenous fistula (FTAVF) presenting as a cause of failed back surgery syndrome is a rare entity. We report a 48-year-old male patient who presented with clinical features of a conus medullaris/cauda equina lesion. He had upper and lower motor neuron signs in both the lower limbs with autonomic dysfunction. The patient was misdiagnosed and was operated twice earlier for lumbar canal stenosis and disc prolapse. After reviewing his clinical and radiological findings a diagnosis of FTAVF was made. He underwent surgery and there was a significant improvement in his neurological functions. We discuss the case and review the literature on FTAVF's.

Ranjan, Alok; Lath, Rahul

2014-01-01

81

Neurinoma of the cauda equina misdiagnosed as prolapsed lumbar disk. Report of three cases.  

PubMed

The authors report three cases of neurinoma of the cauda equina initially misdiagnosed as prolapsed lumbar disk. Computed Tomography failed to reveal the tumour, while showing evidence of disk-degenerative patology and being thus misleading. Similar cases are reported in literature. After a thorough analysis of the causes of such an apparently gross error, it is concluded that the main source of pitfalls arises from neglecting those typical clinical features differentiating prolapsed disk from oncogenetic sciatica. When oncogenetic sciatica is suspected Computed Tomography is inappropriate and even misleading, while the elective investigation is Magnetic Resonance. PMID:7782865

Palma, L; Mariottini, A; Muzii, V F; Bolognini, A; Scarfò, G B

1994-09-01

82

A case of lepromatous leprosy complicated by hemophagocytosis misdiagnosed as hemophagocytic lymphohistiocytosis.  

PubMed

Leprosy is an infectious chronic granulomatous disease caused by Mycobacterium leprae. The disease mainly affects the skin, peripheral nerves, mucosa, and viscera. The World Health Organization has reported that most countries with high endemicity have reached the goal of eliminating leprosy (defined as reaching a prevalence of <1 leprosy case per 10 000 population) at the national level, after years of proactive control campaigns. The incidence of leprosy has been decreasing across the globe year by year. However, misdiagnosis happens occasionally due to the complexity of clinical manifestations and lack of physician awareness of this disease. We report a case of lepromatous leprosy complicated by hemophagocytosis misdiagnosed as hemophagocytic lymphohistiocytosis. PMID:24657272

Zeng, Xiang-Zong; Wang, Yi-Ni; Wang, Jing-Shi; Wu, Lin; Zhang, Jia; Wei, Qing; Liu, Jian; Wang, Zhao

2014-06-01

83

Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers.  

PubMed

A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC. PMID:24575003

Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

84

Successful Treatment of Congenital Lymphangioma Circumscriptum of the Vulva with CO2 and Long-Pulsed Nd:YAG Lasers  

PubMed Central

A 16-year-old girl presented with a 9-year history of vesicles on the vulva. She had initially taken a wait-and-see approach, but required treatment because of bleeding. Histological examination of a biopsied vesicle revealed dilated lymph channels in the upper dermis, suggesting lymphangioma circumscriptum (LC). The challenge for this pathology has been to find a conservative treatment with low morbidity and better results than those reported for surgical excision, which has been the mainstay of therapy. In this case, LC of the vulva was successfully treated using a 10,600-nm CO2 laser and long-pulsed Nd:YAG laser. Use of the 10,600-nm CO2 laser and long-pulsed Nd:YAG laser appeared effective for treating LC.

Sasaki, Ryosuke; Negishi, Kei; Akita, Hirotaka; Suzuki, Kayoko; Matsunaga, Kayoko

2014-01-01

85

Immunohistochemical expression of p16 and p53 in vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva  

Microsoft Academic Search

This study was undertaken to examine the expression of p16 and p53 in vulvar intraepithelial neoplasia (VIN) and squamous\\u000a cell carcinoma (SCC) of the vulva. We also analyzed the relationship between p16 and p53 immunoexpression in women younger\\u000a vs. older than 55 years of age. Seventyseven histologic samples of vulvar tissue, treated surgically between June 2000 and\\u000a November 2004 at

Mauricio Cordoni Nogueira; Ernesto de Paula Guedes Neto; Marcos Wengrover Rosa; Eduardo Zettler; Cláudio Galleano Zettler

2006-01-01

86

Management of a case with misdiagnosed spinal dural arterio-venous fistula.  

PubMed

Abstract Purpose: Spinal dural arterio-venous fistula (SDAVF) is an uncommon and easily misdiagnosed vascular malformation. We aimed to report the diagnosis and management of a case with SDAVF. Case Report: A 62-year-old man suffered from acute paraparesis about 15 months before this study. He underwent a neurosurgical procedure for herniated discs of the cervical spine at that time but there was no relief and the symptoms worsened despite the surgery. Neurologically, he had spastic paraparesis and decreased vibration sensation of the lower limbs. Spinal magnetic resonance imaging (MRI) revealed intra-medullary hyper-intensity lesion at T8 to T10 levels and tubular-like signal void structures in the corresponding posterior sub-arachnoid space. Further trans-arterial angiography through right T6 intercostal artery catheterization revealed engorged veins, thereby confirming the diagnosis of SDAVF. The patient was treated via endovascular embolization (18% Onyx, EV3TM MIT, Bonn, Germany) through spinal angiography and the results showed a marked decrease in engorged veins. After a 4-month follow-up, the patient was symptomatic but stable. Follow-up MRI showed a complete disappearance of the hyper-intensity change of the spinal cord. Spinal MR angiography did not reveal any recurrence of SDAVF. Conclusion: This case study demonstrated the easily misdiagnosed state of SDAVF. Serial neuroimage studies including spinal MRI, endovascular embolization through spinal angiography and MR angiography can be useful tools for its diagnostic confirmation, management and follow-up study. PMID:24833213

Lien, Chia-Yi; Lui, Chun-Chung; Lu, Cheng-Hsien; Chang, Wen-Neng

2014-03-01

87

Dopa-responsive Dystonia with a Novel Initiation Codon Mutation in the GCH1 Gene Misdiagnosed as Cerebral Palsy  

PubMed Central

Dopa-responsive dystonia (DRD) is a clinical syndrome characterized by childhood-onset dystonia and a dramatic response to relatively low doses of levodopa. However, patients with DRD can be misdiagnosed as cerebral palsy or spastic diplegia due to phenotypic variation. Here we report a young woman with DRD who were severely disabled and misdiagnosed as cerebral palsy for over 10 yr. A small dose of levodopa restored wheelchair-bound state to normality. However, thoracolumbar scoliosis has remained as a sequel due to late detection of DRD. Genetic analysis by using PCR-direct sequencing revealed a novel initiation codon mutation (c.1A>T; p.Met1Leu) in GTP cyclohydrolase 1 (GCH1) gene. Although it is known that DRD can be misdiagnosed as cerebral palsy, this case reinforces the importance of differential diagnosis of DRD from cerebral palsy.

Lee, Jae-Hyeok; Kim, Dae-Seong; Cho, Jae-Wook; Park, Kyung-Phil; Kim, Seonhye

2011-01-01

88

A persistently recurring peri-urethral soft tissue lesion of the vulva.  

PubMed

Various mesenchymal lesions, some of which have only recently been characterized, may affect the vulva. Because of their apparently shared origin from vulvovaginal mesenchyme, these lesions can resemble one another superficially and can be challenging diagnostically. Clinically, benign lesions and tumor-like conditions may mimic a malignant process because of hypercellularity, mitotic activity, and rapid growth. We report on a 84-year-old diabetic and hypertensive woman who had previously undergone skinning vulvectomy for lichen planus and an embolectomy of the left femoral artery. The patient presented with a rapidly growing vulvar mass. The biopsy showed spindle cell proliferation in a loose myxoid stroma with granulation tissue and a mixed inflammatory infiltrate. Based on histology and immunohistochemistry, the initial diagnosis was that of a benign lesion. In view of the persistent recurrence of the lesion and the absence of metastatic spread, we conclude that the lesion has a low-grade malignant potential and suggest the diagnosis of florid cellular reactive pseudosarcomatous myofibroblastic proliferation. PMID:15807313

Leunen, M; Goossens, A; Bourgain, C; De Sutter, P; Michielsen, D; Amy, J J

2005-01-01

89

Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?  

PubMed Central

Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed.

Rodriguez, Veronica Garza; De la Fuente Garcia, Alberto; Torres, Myrna Alejandra Cardoza; Flores, Minerva Gomez; Moreno, Gildardo Jaramillo; Candiani, Jorge Ocampo

2014-01-01

90

Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?  

PubMed

Basal cell carcinomas (BCC) on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS) is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed. PMID:24860751

Rodríguez, Verónica Garza; De la Fuente García, Alberto; Torres, Myrna Alejandra Cardoza; Flores, Minerva Gómez; Moreno, Gildardo Jaramillo; Candiani, Jorge Ocampo

2014-04-01

91

Pseudodyssynergia (Contraction of the External Sphincter During Voiding) Misdiagnosed as Chronic Nonbacterial Prostatitis and the Role of Biofeedback as a Therapeutic Option  

Microsoft Academic Search

PurposeChronic lower urinary tract symptoms in young men are often attributed to misdiagnosed chronic nonbacterial prostatitis. We analyzed contraction of the external urinary sphincter during voiding (pseudodyssynergia) as an etiology of voiding dysfunction in men with misdiagnosed chronic prostatitis.

Steven A. Kaplan; Richard P. Santarosa; Patricia Meade D'Alisera; Brenda J. Fay; Edward F. Ikeguchi; James Hendricks; Lonnie Klein; Alexis E. Te

1997-01-01

92

Robotic-assisted surgery approach in a biliary rhabdomyosarcoma misdiagnosed as choledochal cyst.  

PubMed

Rhabdomyosarcoma is a soft tissue malignant tumor affecting 1% of children from 0 to 14 years. Preoperative imaging may not always be diagnostic for hepatobiliary rhabdomyosarcoma and differential diagnosis with choledochal cyst (CC) could be difficult. We report a case of 2-years-old girl with a strange CC pattern of presentation. A grapelike lesion involving the choledochal and biliary ducts was easily and completely resected by robotic assisted surgery. Since no previous reports were available about oncologic safety of robotic approach, the porto-enterostomy was performed in open surgery. On histologic examination, the specimen revealed a botryoidembryonal rhabdomyosarcoma affecting both the common bile duct and the common hepatic duct. One year postoperatively the child is safe of tumor relapse. Robotic approach seems to be safe and advantageous to obtain a radical excision of the tumor at the porta hepatis, even in case of misdiagnosed malignant lesion mimicking a CC. PMID:24711907

Nakib, Ghassan; Calcaterra, Valeria; Goruppi, Ilaria; Romano, Piero; Raffaele, Alessandro; Schleef, Jurgen; Pelizzo, Gloria

2014-01-23

93

Phthiriasis palpebrarum misdiagnosed as allergic blepharoconjunctivitis in a 6-year-old girl.  

PubMed

Phthiriasis palpebrarum is an infestation of the eyelashes caused by the louse Pthirus pubis (Linnaeus, 1758). We report a case of phthiriasis palpebrarum in a 6-year-old girl, which was initially misdiagnosed as allergic blepharoconjunctivitis. Parasites and their nits were found adhering to the eyelashes and eyelids of her right eye as well as scalp hairs. No abnormality was found in the left eye. The histopathology exam revealed the presence of adults and eggs of Pthirus pubis. We mechanically removed all the eyelashes of the right eye at their base, with lice and nits. The scalp was shaved and washed with phenothrin shampoo. No recurrence was found during 3 months of follow-up. Removal of the eyelashes, cutting of scalp hairs, and phenothrin shampoo may be effective in treating phthiriasis palpebrarum. In cases of blepharoconjunctivitis, eyelids and eyelashes should be carefully examined by slit lamp to avoid misdiagnosis. PMID:24909484

Yi, Jun Wen; Li, Li; Luo, Da Wei

2014-01-01

94

Thrombolytic-related complication in a case of misdiagnosed myocardial infarction.  

PubMed

Abstract The importance of early thrombolysis in acute myocardial infarction has been highlighted in several large trials. The clinical decision is often taken by physicians who need to take a rapid action with the risk of misdiagnosing non-coronary events that mimic myocardial infarction. Here we describe a case of acute pericarditis in a 37-year-old man whom received thrombolysis and developed a sudden hemorrhagic pericardial effusion that evolved rapidly into a cardiac tamponade. These errors leading to lethal thrombolysis complications have been surprisingly rare; but a correct diagnosis of aortic dissection or hemorrhagic pericarditis needs to be stressed because even after obtaining the correct diagnosis, the prolonged disturbance of hemostasis prevents a rapid therapy being instigated. PMID:24749992

Irivbogbe, Osereme; Mirrer, Brooks; Loarte, Pablo; Gale, Michael; Cohen, Ronny

2014-06-01

95

Giant cell arteritis misdiagnosed as temporomandibular disorder: a case report and review of the literature.  

PubMed

Giant Cell Arteritis Misdiagnosed as Temporomandibular Disorder: A Case Report and Review of the Literature Shoshana Reiter Ephraim Winocur Carole Goldsmith Alona Emodi-Perlman Meir Gorsky Giant cell arteritis (GCA) is a systemic vasculitis involving medium and large-sized arteries, most commonly the extracranial branches of the carotid artery. Early diagnosis and treatment are essential to avoid severe complications. This article reports on a GCA case and discusses how the orofacial manifestations of GCA can lead to misdiagnosis of GCA as temporomandibular disorder. GCA should be included in the differential diagnosis of orofacial pain in the elderly based on the knowledge of related signs and symptoms, mainly jaw claudication, hard end-feel limitation of range of motion, and temporal headache. PMID:19888487

Reiter, Shoshana; Winocur, Ephraim; Goldsmith, Carole; Emodi-Perlman, Alona; Gorsky, Meir

2009-01-01

96

[Antiphospolipid syndrome related chorea gravidarum case with psychotic symptoms misdiagnosed as conversion disorder: case report].  

PubMed

Chorea gravidarum (CG) is a rare movement disorder characterized by rapid, irregular randomly distributed involuntary movements during pregnancy. Similar to Sydenham chorea, psychiatric symptoms may be observed in cases of CG. CG may be idiopathic or secondary to an underlying cause. One of the most common causes of CG is antiphospholipid syndrome. Herein we present a case of recurrent CG that was considered to be due to antiphospholipid syndrome. The patient had a history of 3 pregnancy losses and her fourth pregnancy was treated appropriately, resulting in the birth of healthy full-term baby. During the patient's first pregnancy CG was accompanied by psychotic symptoms and was misdiagnosed as conversion disorder. PMID:24310096

Kuz Tek?ut, Tuba; Ozcan, Halil; I??k, Mein; Karsl?, Fatih

2013-01-01

97

[Misdiagnosed childhood sarcoidosis as non-Langerhans' cell histiocytosis treated with tumor necrosis factors-? antagonists].  

PubMed

Sarcoidosis is a chronic multisystemic granulomatous disease of unknown origin. Generalised eruptive histiocytosis is a rare, benign, self-healing, non-Langerhans' cell histiocytosis (non-LCH). We report the case of an 8-year-old girl with sarcoidosis who was misdiagnosed as non-LCH. She was treated with oral corticosteroids, methotrexate and adalimumab, but there was insufficient control of ocular disease. The introduction of infliximab achieved a control of the uveitis and enabled the corticosteroid dose to be tapered. In some cases of sarcoidosis the lack of well-organised granuloma formation at the beginning of the disease, and the presence of prominent giant cells may suggest alternative diagnoses, such as non-LCH. Although the experience of tumour necrosis factor-? antagonists use in children with sarcoidosis is limited, these drugs may be helpful for those patients experiencing a severe and refractory disease. PMID:22608978

Petiti Martin, G; Castellanos González, M; Sanz Bueno, J; Burgués Calderón, M; Villar Buil, M; Vanaclocha, F; Peralto, J L

2012-10-01

98

Hereditary Spastic Paraplegia with a Novel SPAST Mutation Misdiagnosed with Subacute Combined Degeneration  

PubMed Central

Autosomal dominant hereditary spastic paraplegia (AD-HSP) is due to mutations in the "spastin" gene (SPAST gene) encoding the AAA protein. The main clinical features of "pure" HSP are progressive lower-limb spasticity with corticospinal tracts and dorsal column degeneration without peripheral neuropathy. Here we report the case of HSP with novel SPAST gene mutation that misdiagnosed with subacute combined degeneration initially. A 58-year-old man with gait disturbance came to our hospital. He was unable to regulate his steps by himself. The impaired gait began 3 years after he had undergone subtotal gastrectomy and chemotherapy for 6 months. Thereafter, he started feeling tingling sensations in the hands and feet and acquired gait difficulties. He denied having a family history of abnormal gait or developmental problem. We diagnosed him with subacute combined degeneration on the evidence of history of gastrectomy, lower normal limit of vitamin B12 (363 pg/ml), apparent absence of vibration sensations and paresthesia in the feet. He was intramuscularly administered cyanocobalamin regularly. However, there was no improvement in his condition. We reconsidered his symptoms and signs, decided to examine the SPAST gene, which is the most common mutation in HSP. The SPAST gene, c.870+1delG, heterozygote, splicing mutation is detected from the gene sample. There was no previous information of this polymorphism or mutation at this locus. We examined his two children, and the same mutation was founded in his son. We report a patient of novel SPAST gene mutation with AD-HSP which is misdiagnosed with SCD.

Yang, Ji Won; Han, Ji-Young; Seong, Moon-Woo; Lee, Kwang-Woo

2013-01-01

99

Premalignant lesions of the lower female genital tract: cervix, vagina and vulva.  

PubMed

Premalignant lesions of the lower female genital tract encompassing the cervix, vagina and vulva are variably common and many, but by no means all, are related to infection by human papillomavirus (HPV). In this review, pathological aspects of the various premalignant lesions are discussed, mainly concentrating on new developments. The value of ancillary studies, mainly immunohistochemical, is discussed at the appropriate points. In the cervix, the terminology and morphological features of premalignant glandular lesions is covered, as is the distinction between adenocarcinoma in situ (AIS) and early invasive adenocarcinoma, which may be very problematic. A spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation is emerging with lobular endocervical glandular hyperplasia (LEGH), including so-called atypical LEGH, representing a possible precursor of non HPV-related cervical adenocarcinomas exhibiting gastric differentiation; these include the cytologically bland adenoma malignum and the morphologically malignant gastric type adenocarcinoma. Stratified mucin producing intraepithelial lesion (SMILE) is a premalignant cervical lesion with morphological overlap between cervical intraepithelial neoplasia (CIN) and AIS and which is variably regarded as a form of reserve cell dysplasia or stratified AIS. It is now firmly established that there are two distinct types of vulval intraepithelial neoplasia (VIN) with a different pathogenesis, molecular events, morphological features and risk of progression to squamous carcinoma. These comprise a more common HPV-related usual type VIN (also referred to as classic, undifferentiated, basaloid, warty, Bowenoid type) and a more uncommon differentiated (simplex) type which is non-HPV related and which is sometimes associated with lichen sclerosus. The former has a relatively low risk of progression to HPV-related vulval squamous carcinoma and the latter a high risk of progression to non-HPV related vulval squamous carcinoma. Various aspects of vulval Paget's disease are also discussed. PMID:23442737

McCluggage, W Glenn

2013-04-01

100

Diagnostic criteria for erosive lichen planus affecting the vulva: an international electronic-Delphi consensus exercise  

PubMed Central

Background There is no defined set of criteria for diagnosing erosive lichen planus affecting the vulva (ELPV) and there is geographical variation in management. Objectives To reach consensus on clinicopathological diagnostic criteria for ELPV. Methods This was a three-stage international electronic-Delphi exercise with a subsequent formal feedback process. In the first two rounds participants were asked to rate the importance of a list of clinicopathological criteria. Responses from round 1 were summarized and presented in round 2, along with additional criteria suggested by participants. In round 3, participants were asked to rate the items that had reached consensus as ‘essential’ or ‘supportive’ features in diagnosing ELPV. Consensus was defined as being reached if 75% of participants agreed on the importance of an item. Results A total of 73 experts representing dermatology, gynaecology, histopathology and genitourinary medicine participated; 69 (95%) completed all three rounds. Consensus was achieved for the following ‘supportive’ diagnostic criteria: (i) well-demarcated erosions/erythematous areas at the vaginal introitus; (ii) presence of a hyperkeratotic border to lesions and/or Wickham striae in surrounding skin; (iii) symptoms of pain/burning; (iv) scarring/loss of normal architecture; (v) presence of vaginal inflammation; (vi) involvement of other mucosal surfaces; (vii) presence of a well-defined inflammatory band involving the dermoepidermo junction; (viii) presence of an inflammatory band consisting predominantly of lymphocytes; and (ix) signs of basal layer degeneration. It was suggested that at least three supportive features should be present to make a diagnosis of ELPV, although this number is subject to further discussion. Conclusions This study has identified a diagnostic dataset for ELPV that can be adopted into clinical practice and clinical trials.

Simpson, RC; Thomas, KS; Leighton, P; Murphy, R

2013-01-01

101

Sebaceous hyperplasia of the vulva: a series of cases reporting no association with the muir-torre syndrome.  

PubMed

Sebaceous gland hyperplasia is a common skin condition, very rarely reported in the female genital region. We present 13 cases from 12 patients, the first case series of sebaceous gland hyperplasia of the vulva. Differences in age at presentation and clinical presentation compared with classic sebaceous gland hyperplasia from the head and neck region were noted. Also, it was rarely included in the clinical differential diagnosis. Immunohistochemical studies to determine any possible association with the Muir-Torre syndrome were performed and mismatch repair protein loss was not identified. PMID:24901406

Roma, Andres A; Barry, Jessica; Pai, Rish K; Billings, Steven D

2014-07-01

102

Uterine leiomyoma associated non-puerperal uterine inversion misdiagnosed as advanced cervical cancer: A case report?  

PubMed Central

INTRODUCTION Uterine inversion is an un-common complication of parturition which often occurs in the immediate postpartum period. The chronic (non-puerperal) uterine inversion is rarer and most times tumour associated. PRESENTATION OF CASE A 51-year old grand multiparous lady presented with a month history of abnormal vaginal bleeding associated with offensive vaginal discharge, lower abdominal pain and dizziness. The initial evaluation suggested severe anaemia secondary to advanced cervical cancer. Examination under anaesthesia (EUA), staging and biopsy was attempted but this was however inconclusive due to profuse haemorrhage. A repeat EUA revealed chronic uterine inversion secondary to fundal submucous uterine leiomyoma. Myomectomy was done with tissue histology confirming benign uterine leiomyoma. Two weeks later, a modified Haultain's procedure was done followed by simple hysterectomy and posterior colpoperineorrhaphy. She had satisfactory recovery. DISCUSSION This is the first reported case of chronic non-puerperal uterine inversion in our hospital. When it occurs, it is usually tumour associated with the commonest tumour being prolapsed myoma and leiomyosarcoma. The diagnosis is based on high index of suspicion. CONCLUSION Chronic uterine inversion is a rare gynaecological condition and can be misdiagnosed as advanced cervical cancer or other causes of severe genital haemorrhage in women. A high index of suspicion is needed for its proper diagnosis. Sometimes, an EUA and biopsy was required to determine the cause here and conveniently it could be described as a “gynaecolological near miss”.

Umeononihu, Osita Samuel; Adinma, Joseph Ifeanyi; Obiechina, Nworah J.; Eleje, George Uchenna; udegbunam, Onyebuchi Izuchukwu; Mbachu, Ikechukwu Innocent

2013-01-01

103

Atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy: case reports  

PubMed Central

Background To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy. Case presentation Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Fluorescein angiography showed multiple leakages around the central hypofluorescent area and indocyanine green angiography showed partially dilated choroidal vessels. Fundus autofluorescence (FAF) showed a decreasing pattern of autofluorescence in the subretinal fluid area, and increasing autofluorescence at the border of the serous retinal detachment. Both patients were diagnosed with chronic central serous chorioretinopathy. Photodynamic therapy and intravitreal bevacizumab injection were administered for engorged choroidal vessels during follow-up, but neither patient showed improvement in symptoms or ophthalmologic findings. Based on re-evaluation by fundus photography, optical coherence tomography, fluorescein angiography, and comparison of the results of FAF with the first visit, vitelliform macular dystrophy was suspected and a definite diagnosis was made by electrooculography and genetic testing. Conclusion In patients with continuous serous retinal detachment without response to photodynamic therapy or intravitreal bevacizumab injection, careful fundus exam and FAF can be used to diagnose atypical vitelliform macular dystrophy.

2012-01-01

104

Improving the management of imported schistosomiasis haematobia in China: lessons from a case with multiple misdiagnoses  

PubMed Central

Background Human Schistosoma haematobium infection that causes urinary schistosomiasis occurs in Africa and the eastern Mediterranean, and China is only endemic for S. japonicum. In this report, we reported an imported case with S. haematobium infection returning from Angola to Shaanxi Province, northwestern China, where S. japonicum is not endemic. Findings The case was misdiagnosed as ureteral calculus, invasive urothelial carcinoma and eosinophilic cystitis in several hospitals, and was finally diagnosed by means of serological assay followed by microscopic examination of the urine sediment. The patient was then treated with praziquantel, and a satisfactory outcome was obtained. Conclusions As S. haematobium is not indigenous to China, most Chinese doctors and medical technicians are unfamiliar with this introduced parasitic disease, therefore, they need to increase the awareness of its existence when they encounter persons who have visited or resided in endemic areas, and the techniques for detection of the parasite, so as to reduce the misdiagnosis. In addition, health education should be given to those who will go to the endemic areas to improve their knowledge and awareness on prevention and control of schistosomiasis haematobia, thereby reducing the risk of exposure to the infested freshwater.

2013-01-01

105

A case of diffuse large B-cell lymphoma misdiagnosed as an erysipelas of the face  

PubMed Central

We report a case of a woman with diffuse large B-cell lymphoma (DLBCL). Primary cutaneous lymphomas (PCLs) represent distinct clinical and histopathologic subtypes of extranodal T- and B-cell lymphomas. Cutaneous B-cell lymphomas comprise 20–25% of all primary cutaneous lymphomas. The patient presented an erythematous tumour mass of the left nasolabial fold, nose and left cheek as well as disseminated infiltrative plagues on the trunk, arms and left lower leg. Skin biopsy revealed a diffuse infiltrate of lymphocytes around hair follicles and blood vessels within dermis and subcutaneous tissue. An immunohistochemistry showed a diffuse infiltrate of large non-cleaved B-cells, with a high proportion of centroblast-like cells within dermis. Tumor cells expressed CD20, bcl-2 protein and did not express CD10. The patient was misdiagnosed as the erysipelas of the face and unsuccessfully treated with long-term antibiotic therapy by a laryngologist and a dermatologist. The correct diagnosis was delayed and established after 6 months’ history of DLBCL lesions. Therefore, we would like to strongly stress the importance of considering diagnosis of cutaneous lymphomas in chronic skin lesions non-responsive to adequate therapies.

Szymanska, Magdalena; Czarnecka-Operacz, Magdalena

2013-01-01

106

A case of diffuse large B-cell lymphoma misdiagnosed as an erysipelas of the face.  

PubMed

We report a case of a woman with diffuse large B-cell lymphoma (DLBCL). Primary cutaneous lymphomas (PCLs) represent distinct clinical and histopathologic subtypes of extranodal T- and B-cell lymphomas. Cutaneous B-cell lymphomas comprise 20-25% of all primary cutaneous lymphomas. The patient presented an erythematous tumour mass of the left nasolabial fold, nose and left cheek as well as disseminated infiltrative plagues on the trunk, arms and left lower leg. Skin biopsy revealed a diffuse infiltrate of lymphocytes around hair follicles and blood vessels within dermis and subcutaneous tissue. An immunohistochemistry showed a diffuse infiltrate of large non-cleaved B-cells, with a high proportion of centroblast-like cells within dermis. Tumor cells expressed CD20, bcl-2 protein and did not express CD10. The patient was misdiagnosed as the erysipelas of the face and unsuccessfully treated with long-term antibiotic therapy by a laryngologist and a dermatologist. The correct diagnosis was delayed and established after 6 months' history of DLBCL lesions. Therefore, we would like to strongly stress the importance of considering diagnosis of cutaneous lymphomas in chronic skin lesions non-responsive to adequate therapies. PMID:24278087

Teresiak-Miko?ajczak, Ewa; Szyma?ska, Magdalena; Czarnecka-Operacz, Magdalena

2013-08-01

107

Platelet-type von Willebrand disease: a rare, often misdiagnosed and underdiagnosed bleeding disorder.  

PubMed

Platelet-type von Willebrand disease (PT-VWD) is an autosomal dominant rare bleeding disorder characterized by hyperresponsive platelets. This inherent platelet function defect is due to a gain-of-function mutation within the GP1BA gene coding for the platelet surface glycoprotein Ib alpha protein, the receptor for the adhesive protein von Willebrand factor (VWF). The defect results in excessive and unnecessary platelet-VWF interaction with subsequent removal of the hemostatically efficient high molecular weight VWF as well as platelets from the circulation, leading to thrombocytopenia and bleeding diathesis. Patients with PT-VWD present with mild to moderate mucocutaneous bleeding, which becomes more pronounced during pregnancy and following aspirin ingestion or drugs that have antiplatelet activity. Laboratory testing shows low VWF:ristocetin cofactor and low or normal VWF:antigen and characteristically an enhanced ristocetin-induced platelet agglutination (RIPA). These laboratory features are also indicators of the closely similar and more common bleeding disorder type 2B VWD. Simplified RIPA mixing assays, cryoprecipitate challenge, and flow cytometry can differentiate between the two disorders. However, the gold standard is to identify mutations within the VWF gene (indicating type 2B VWD) or the platelet GP1BA gene (confirming PT-VWD). Treatment is based on making a correct diagnosis of PT-VWD where platelet concentrates instead of VWF/factor VIII preparations should be administered. A recent fairly large retrospective/prospective registry-based international study showed that PT-VWD is very rare, likely to be misdiagnosed as type 2B VWD or idiopathic thrombocytopenic purpura, and represents 15% of type 2B VWD diagnoses. PMID:22102188

Othman, Maha

2011-07-01

108

Unusual mucoepidermoid carcinoma of the liver misdiagnosed as squamous cell carcinoma by intraoperative histological examination  

PubMed Central

As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic mucoepidermoid carcinoma misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive jaundice, epigastric discomfort, and weight loss with slightly increased carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod carcinoma of liver by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060

2014-01-01

109

The basement membrane zone and dermal extracellular matrix in erosive lichen planus of the vulva: an immunohistochemical study demonstrating altered expression of hemidesmosome components and anchoring fibrils.  

PubMed

Histopathology demonstrates disruption of the basal layer of the epidermis in lichen planus (LP) and altered expression of basement membrane zone (BMZ) components occurs in cutaneous and oral LP. This is the first study in erosive LP of the vulva to investigate the expression of components of the BMZ and extracellular matrix by indirect immunofluorescence. Six biopsies from lesional vulval erosive LP were compared with two biopsies from normal vulva and five biopsies from normal skin. In erosive vulval LP there was widespread disruption of several BMZ components compared to normal skin. The hemidesmosome antigens were disrupted and attenuated, or absent. Expression of lamina lucida proteins and anchoring filaments also showed some alteration. Lamina densa components were altered and in particular there was very marked thickening, streaking and fragmentation of the anchoring fibrils. Some dermal extracellular matrix proteins were increased. This study has demonstrated widespread damage to the BMZ in erosive LP of the vulva, in particular the hemidesmosomes (alpha6beta4 integrin, BP230, BP180) and anchoring fibrils (collagen VII). This suggests an alteration in antigenic expression in the BMZ that may lead to exposure of epitopes and thus make these proteins vulnerable to attack by autoantibodies. PMID:15807689

Cooper, S M; Prenter, A; Allen, J; Dean, D; Wojnarowska, F

2005-05-01

110

Clear cell sarcoma of the kidney misdiagnosed as mesoblastic nephroma: a case report and review of the literature  

PubMed Central

Clear cell sarcoma of the kidney (CCSK) is a rare renal neoplasm of paediatrics, making up about 3% of all renal tumours in paediatrics, with a high tendency for developing bone metastasis. A seven year-old boy was referred to our clinic with two firm, large masses over the manubrium of the sternum and right frontal area, which pathologically were confirmed as a metastatic CCSK. The patient had a history of a renal mass three years earlier, for which radical nephrectomy had been performed, and histopathologic diagnosis was compatible with mesoblastic nephroma. Thus, no further investigation and therapy had been applied for the patient. CCSK is a rare but malignant and aggressive paediatric renal tumour, with a high tendency for developing distant bone metastases, leading to its poor prognosis. CCSK could be misdiagnosed as several other renal tumours such as mesoblastic nephroma, and thus CCSK should be taken carefully into consideration in the diagnosis of renal tumours.

Alavi, Samin; Khoddami, Maliheh; Yazdi, Mohammad Kaji; Dehghanian, Paria; Esteghamati, Sadaf

2013-01-01

111

A very late recurrence of a formerly misdiagnosed low grade endometrial stromal sarcoma metastasized to the colon?  

PubMed Central

INTRODUCTION Endometrial stromal sarcomas are rare mesenchymal neoplasms of the uterus with an indolent clinical course but a high risk of recurrence. PRESENTATION OF CASE We report a case of a 78 year old woman who presented with rectal bleeding and recurrent urinary tract infections, caused by a very late recurrence of a formerly misdiagnosed low grade endometrial stromal sarcoma, metastasized to the colon. DISCUSSION Endometrial stromal sarcomas are difficult to diagnose, both due to the rarity of the tumor and because of the close resemblance of the tumor to normal stromal tissue. These tumors are known for a high tendency of recurrence, therefore long term follow up is required in patients with endometrial stromal sarcoma. CONCLUSION In patients with a history known for endometrial stromal sarcoma recurrence should always be considered.

Bakker, Ilsalien S.; Hoven-Gondrie, Miriam L.; Moll, Freek C.P.; de Haan, Harm H.

2013-01-01

112

Fatal Case of Brucellosis Misdiagnosed in Early Stages of Brucella suis Infection in a 46-Year-Old Patient with Marfan Syndrome  

PubMed Central

We report a fatal case of Brucella suis endocarditis initially misdiagnosed by automated identification systems as Ochrobactrum anthropi infection in a patient with a history of Marfan syndrome and recreational feral swine hunting. This report emphasizes the need to consider brucellosis as a part of the differential diagnosis of acute febrile illness, particularly in patients with known risk of exposure.

Carrington, M.; Choe, U.; Ubillos, S.; Stanek, D.; Campbell, M.; Wansbrough, L.; Lee, P.; Churchwell, G.; Rosas, K.; Zaki, S. R.; Drew, C.; Paddock, C. D.; DeLeon-Carnes, M.; Guerra, M.; Hoffmaster, A. R.; Tiller, R. V.

2012-01-01

113

Bilateral Paget's Disease of the Breast--Case Report of Long-Time Misdiagnosed Tumors with Underlying Ductal Carcinomas and Review of the Literature  

PubMed Central

Paget's disease of the breast is often misdiagnosed. We report on a 72-year old patient with a history of 2.5 years without any malignant findings, followed by the identification of a bilateral Paget's disease with bilateral breast cancers. This case underlines how important histological examinations even in unusual clinical pictures are.

Barth, Dietrich

2014-01-01

114

Caenorhabditis elegans Histone Deacetylase hda-1 Is Required for Morphogenesis of the Vulva and LIN-12/Notch-Mediated Specification of Uterine Cell Fates  

PubMed Central

Chromatin modification genes play crucial roles in development and disease. In Caenorhabditis elegans, the class I histone deacetylase family member hda-1, a component of the nucleosome remodeling and deacetylation complex, has been shown to control cell proliferation. We recovered hda-1 in an RNA interference screen for genes involved in the morphogenesis of the egg-laying system. We found that hda-1 mutants have abnormal vulva morphology and vulval-uterine connections (i.e., no uterine-seam cell). We characterized the vulval defects by using cell fate-specific markers and found that hda-1 is necessary for the specification of all seven vulval cell types. The analysis of the vulval-uterine connection defect revealed that hda-1 is required for the differentiation of the gonadal anchor cell (AC), which in turn induces ventral uterine granddaughters to adopt ? fates, leading to the formation of the uterine-seam cell. Consistent with these results, hda-1 is expressed in the vulva and AC. A search for hda-1 target genes revealed that fos-1 (fos proto-oncogene family) acts downstream of hda-1 in vulval cells, whereas egl-43 (evi1 proto-oncogene family) and nhr-67 (tailless homolog, NHR family) mediate hda-1 function in the AC. Furthermore, we showed that AC expression of hda-1 plays a crucial role in the regulation of the lin-12/Notch ligand lag-2 to specify ? cell fates. These results demonstrate the pivotal role of hda-1 in the formation of the vulva and the vulval-uterine connection. Given that hda-1 homologs are conserved across the phyla, our findings are likely to provide a better understanding of HDAC1 function in development and disease.

Ranawade, Ayush Vasant; Cumbo, Philip; Gupta, Bhagwati P.

2013-01-01

115

Different DNA damage and cell cycle checkpoint control in low- and high-risk human papillomavirus infections of the vulva.  

PubMed

Human papillomavirus (HPV) infections may result in benign hyperplasia, caused by low-risk HPV types, or (pre)malignant lesions caused by high-risk HPV types. The molecular basis of this difference in malignant potential is not completely understood. Here, we performed gene profiling of different HPV infected vulvar tissues (condylomata acuminata (n = 5), usual type vulvar intraepithelial neoplasia (uVIN) (n = 9)) and control samples (n = 14) using Affymetrix Human U133A plus 2 GeneChips. Data were analyzed using OmniViz®, Partek® and Ingenuity® Software. Results were validated by real-time RT-PCR and immunostaining. Although similarities were observed between gene expression profiles of low- and high-risk HPV infected tissues (e.g., absence of estrogen receptor in condylomata and uVIN), high-risk HPV infected tissues showed more proliferation and displayed more DNA damage than tissues infected with low-risk HPV. These observations were confirmed by differential regulation of cell cycle checkpoints and by increased expression of DNA damage-biomarkers p53 and ?H2AX. Furthermore, FANCA, FANCD2, BRCA1 and RAD51, key players in the DNA damage response, were significantly upregulated (p < 0.05). In addition, we compared our results with publicly available gene expression profiles of various other HPV-induced cancers (vulva, cervix and head-and-neck). This showed p16(INK4a) was the most significant marker to detect a high-risk HPV infection, but no other markers could be found. In conclusion, this study provides insight into the molecular basis of low- and high-risk HPV infections and indicates two main pathways (cell cycle and DNA damage response) that are much stronger affected by high-risk HPV as compared to low-risk HPV. PMID:21815142

Santegoets, Lindy A M; van Baars, Romy; Terlou, Annelinde; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; van der Meijden, Willem I; Helmerhorst, Theo J M; Blok, Leen J

2012-06-15

116

Localized lymphedema of the vulva: a clinicopathologic study of 2 cases and a review of the literature.  

PubMed

This report describes 2 cases of localized vulvar lymphedema that were diagnosed in 2 morbidly obese women, including a unique case of a massive localized vulvar lymphedema associated with lymphangioma circumscriptum of the vulva. Herein, we also review previously reported cases of vulvar lymphedema and discuss differential diagnostic considerations. Our review of the recent literature showed 17 cases that we considered approximately similar, reported under the appellations "vulvar lymphoedematous pseudotumor," "massive vulval edema," "vulvar hypertrophy with lymphedema," and "localized lymphedema (elephantiasis)." The patients ranged in age from 19 to 59 years (average 38.5 yrs), and typically presented with papillomatous plaques, skin polyps, generalized vulvar enlargement, or massive pedunculated masses that had been present for durations that ranged from 3 months to 36 years. The average lesional size was 6.1 cm (range: 0.6 - 45 cm), and 10 (59%) of the 17 cases were 3 cm or less. Excisions were generally curative, although persistent or recurrent disease was reported in 3 cases. The patients were overweight in 9 (75%) of the 12 cases in which the patient weight was noted, and 2 others had chronic immobilization. Stromal edema was the only morphologic finding that was uniformly seen in all 17 cases. However, the following morphologic features were identified in significant subsets: multinucleated giant cells, dermal fibrosis, dermal lymphangiectasia, dermal chronic inflammation, perivascular chronic inflammation (superficial and/or deep), hyperkeratosis, acanthosis, and blood vessels of varying calibers. Several attributes of localized vulvar lymphedema may cause them to closely mimic aggressive angiomyxoma, a differential diagnosis that is herein discussed in detail. Localized vulvar lymphedema may also be a small lesion, and can potentially mimic other myxedematous tumors of the vulvovaginal region. The strongest clinical association is with obesity. The term "localized vulvar lymphedema" is an appropriate generic descriptor for the spectrum of lesions whose fundamental and underlying etiology is thought to be chronic lymphedema. PMID:21464721

Fadare, Oluwole; Brannan, Scott M; Arin-Silasi, Dan; Parkash, Vinita

2011-05-01

117

Role of paclitaxel and cisplatin as the neoadjuvant treatment for locally advanced squamous cell carcinoma of the vulva  

PubMed Central

Objective The therapeutic outcomes of patients with advanced vulvar cancer are poor. Multi-modality treatments including concurrent chemoradiation or different regimens of neoadjuvant chemotherapy (NACT), and surgery have been explored to reduce the extent of surgery and morbidity. The present single-institution trial aimed to evaluate the efficacy and toxicity of paclitaxel and cisplatin in locally advanced vulvar cancer. Methods From 2002 to 2009, 10 patients with stage III-IV locally advanced squamous cell carcinoma of the vulva were prospectively treated with 3 courses of paclitaxel-ifosfamide-cisplatin or paclitaxel-cisplatin. Nine of them subsequently underwent radical local excision or radical partial vulvectomy and bilateral inguino-femoral lymphadenectomy. Results The clinical response rate of all enrolled patients was 80%, whereas the pathological responses included 1 case with complete remission, 2 with persistent carcinoma in situ, and 6 invasive cancer cases with tumor shrinkage of more than 50%. Four patients had positive nodes. Forty percent of patients experienced grade 3-4 bone marrow toxicity, which was successfully managed with granulocyte-colony stimulating factor, even in cases of elderly patients. Median progression-free survival after surgery was 14 months (range, 5 to 44 months). Six of the 7 recurrent cases were local, and 3 of them were treated with salvage surgery while the other 3 received radiation with or without chemotherapy. After a median follow-up period of 40 months (range, 5 to 112 months), 55.5% of patients remained alive with no evidence of disease, including 2 long-term survivors after recurrence at 5 and 9 years. Conclusion Based on the high response rate and manageable toxicity, NACT with paclitaxel and cisplatin with or without ifosfamide followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer.

Zanaboni, Flavia; Martinelli, Fabio; Scasso, Santiago; Laufer, Joel; Ditto, Antonino

2014-01-01

118

Lymphatic Mapping and Sentinel Lymph Node Biopsy in Women With Squamous Cell Carcinoma of the Vulva: A Gynecologic Oncology Group Study  

PubMed Central

Purpose To determine the safety of sentinel lymph node biopsy as a replacement for inguinal femoral lymphadenectomy in selected women with vulvar cancer. Patients and Methods Eligible women had squamous cell carcinoma, at least 1-mm invasion, and tumor size ? 2 cm and ? 6 cm. The primary tumor was limited to the vulva, and there were no groin lymph nodes that were clinically suggestive of cancer. All women underwent intraoperative lymphatic mapping, sentinel lymph node biopsy, and inguinal femoral lymphadenectomy. Histologic ultra staging of the sentinel lymph node was prescribed. Results In all, 452 women underwent the planned procedures, and 418 had at least one sentinel lymph node identified. There were 132 node-positive women, including 11 (8.3%) with false-negative nodes. Twenty-three percent of the true-positive patients were detected by immunohistochemical analysis of the sentinel lymph node. The sensitivity was 91.7% (90% lower confidence bound, 86.7%) and the false-negative predictive value (1-negative predictive value) was 3.7% (90% upper confidence bound, 6.1%). In women with tumor less than 4 cm, the false-negative predictive value was 2.0% (90% upper confidence bound, 4.5%). Conclusion Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected women with squamous cell carcinoma of the vulva.

Levenback, Charles F.; Ali, Shamshad; Coleman, Robert L.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

2012-01-01

119

[Epidermolytic hyperkeratosis of the vulva associated with basal cell carcinoma in a patient with vaginal condyloma acuminatum and vaginal intraepithelial neoplasia harboring HPV, type 42].  

PubMed

The occurrence of basal cell carcinoma (BCC) of the vulva is rare. We report the case of a 79-year-old woman with a medical history of intravaginal condyloma acuminatum and vaginal intraepithelial neoplasia 3 (VaIN 3) who presented with a solitary whitish lesion sized 8x5 mm with a central desquamation located on the right labium majus. Histopathologic examination revealed a typical superficial and nodular BCC. Additionally, there were multiple remarkable foci of epidermolytic hyperkeratosis (EH). These foci both merged with superficial BCC or were sharply demarcated from the tumor. Retrospective molecular-biological examination of all the available material revealed HPV type 42 in both condyloma acuminatum and VaIN 3 specimen but not in the BCC associated with EH. To our best knowledge, involvement of the lower female genitalia by EH is a rare finding with six cases published to date. Awareness of EH in this location and its distinction is important because it may be potentially misinterpreted as a viral condyloma. Keywords: vulva - basal cell carcinoma - epidermolytic hyperkeratosis - human papillomavirus. PMID:24758505

Kacerovská, Denisa; Michal, Michal; Kašpírková, Jana; Kazakov, Dmitry V

2014-04-01

120

Primary Immunodeficiency May Be Misdiagnosed as Cow's Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital.  

PubMed

Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cow's milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3?mo and 6?y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis. PMID:24198970

Melo, Karina Mescouto; Dantas, Ellen; De Moraes-Pinto, Maria Isabel; Condino-Neto, Antonio; Gonzalez, Isabela G S; Mallozi, Marcia C; Franco, Jackeline M; Costa-Carvalho, Beatriz T

2013-01-01

121

Primary Immunodeficiency May Be Misdiagnosed as Cow's Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital  

PubMed Central

Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cow's milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3?mo and 6?y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis.

Melo, Karina Mescouto; Dantas, Ellen; De Moraes-Pinto, Maria Isabel; Condino-Neto, Antonio; Gonzalez, Isabela G. S.; Mallozi, Marcia C.; Franco, Jackeline M.; Costa-Carvalho, Beatriz T.

2013-01-01

122

Pelizaeus-Merzbacher Disease, Easily Misdiagnosed as Cerebral Palsy: A Report of a Three-generation Family.  

PubMed

Pelizaeus-Merzbacher disease (PMD) is an X-linked recessive disorder affecting myelination of the central nervous system, and is caused by mutations of the proteolipid protein 1 (PLP1) gene. Clinical manifestations of PMD are variable and major features include progressive nystagmus, spasticity, tremor, ataxia, and psychomotor delay. We describe a classical PMD patient who had been misdiagnosed as cerebral palsy. He had nystagmus and psychomotor delay since infancy and tremor with ataxia developing gradually. Brain MRI revealed demyelination over white matter of the cerebral hemispheres and posterior limbs of the internal capsules. Positive family history led to subsequent mutation analysis, which identified a novel mutation (c.88G>C) in PLP1 in the proband, as well as his affected brother and maternal uncle, and asymptomatic maternal grandmother, mother and two sisters. Therefore, PMD should be considered in a cerebral palsy-like patient with or without positive family history. Mutation analysis is crucial for early diagnosis and further genetic counseling. PMID:23597542

Chen, Yen-Chun; Liang, Wen-Chen; Su, Yi-Ning; Jong, Yuh-Jyh

2014-04-01

123

A Rare Case of Extrafollicular Adenomatoid Odontogenic Tumour in the Posterior Region of the Mandible: Misdiagnosed as Residual Cyst  

PubMed Central

Adenomatoid odontogenic tumor is a relatively uncommon distinct odontogenic neoplasm. It is an uncommon tumor of odontogenic origin with varying number of ductlike structures and inductive changes in the stroma. It is a benign and slow growing epithelial tumor and represents 3% of all odontogenic tumors. Its occurrence is more common in anterior region of the maxilla than mandible. Most of the adenomatoid odontogenic tumors occur intra-osseously but few peripheral variant have been reported which are attached to the gingival structures. The intra-osseous Adenomatoid odontogenic tumor may be related to unerrupted tooth (follicular varient) or may not (extrafollicular varient) be related to unerrupted tooth. This paper is to present a rare case of an extrafollicular Adenomatoid odontogenic tumor occurring in the body of the mandible in a male patient which is distinct and secondly it was clinically and radiographically diagnosed as residual cyst. The diagnosis of Adenomatoid odontogenic tumor was confirmed by Histopathological investigation. How to cite this article: Shivali V, Khanna VD, Khanna P, Singh A, Pandey A, Ahuja T. A Rare Case of Extrafollicular Adenomatoid Odontogenic Tumour in the Posterior Region of the Mandible: Misdiagnosed as Residual Cyst. J Int Oral Health 2013; 5(5):124-8.

Shivali, Vaid; Pandey, Anil; Khanna, Vidhi D; Khanna, Prateek; Singh, Ashish; Ahuja, Tarun

2013-01-01

124

[Report of a case of glucagonoma misdiagnosed as "eczema" and "hepatic angioma" for three years and review of literature].  

PubMed

Glucagonoma is a rare pancreatic tumor, necrolytic migratory erythema is its distinctive feature and it is often associated with diabetes mellitus, weight loss, anemia, hypoaminoacidemia, glossitis and stomatitis. We reported a case of glucagonoma misdiagnosed as "eczema" and "benign hepatic anginoma" for 3 years. His blood glucagon level was 1,758 ng/L. The results of abdominal B-mode ultrasonography and CT scan were negative, but selected arteriogram showed a tumor mass between the pancreatic body and tail. Before operation, treatment with octreotide and supply of amino acids were given with improvement of the skin lesion. After resection of the tumor from pancreas, necrolytic migratory erythema disapeared, but his blood level of glucagon and amino acids did not improve. It is suggested that any diabetic patient with chronic skin damage should be checked for blood glucagon level. In suspected cases, selected arteriogram will be helpful for location of the tumor. Vigorous resection of the pancreatic tumor should be done as soon as possible, even though there is already metastases. PMID:7648942

Dai, W; Shi, Y; Cai, L

1995-03-01

125

Update on intraepithelial neoplasia of the vulva: proceedings of a Workshop at the 2009 World Congress of the International Society for the Study of Vulvovaginal Diseases, Edinburgh, Scotland, September 2009.  

PubMed

A workshop on updates on intraepithelial neoplasia of the vulva was held at the 2009 World Congress of the International Society for the Study of Vulvovaginal Diseases in Edinburgh, Scotland, September 2009. This is a review of the information presented. PMID:20885166

Heller, Debra S; van Seters, Manon; Marchitelli, Claudia; Moyal-Barracco, Michelline; Preti, Mario; van Beurden, Marc

2010-10-01

126

Paraneoplastic stiff person syndrome associated with colon cancer misdiagnosed as idiopathic Parkinson's disease worsened after capecitabine therapy  

PubMed Central

Objectives To refresh clinical diagnostic dilemmas in patients presenting with symptoms resembling to those of parkinsonism, to report rare association of colon cancer and paraneoplastic stiff person syndrome (SPS), and to draw attention on the possible correlation of capecitabine therapy with worsening of paraneoplastic SPS. Methods Case report of the patient with paraneoplastic SPS due to colon cancer that was misdiagnosed as idiopathic Parkinson’s disease (iPD), whose symptoms worsened after beginning adjuvant capecitabine chemotherapy. Results We describe a 55-year-old woman with subacute onset of symmetrical stiffness and rigidity of the truncal and proximal lower limb muscles that caused lower body bradykinesia, gait difficulties, and postural instability. Diagnose of iPD was made and levodopa treatment was initiated but failed to provide beneficial effect. Six months later, colon cancer was discovered and the patient underwent surgical procedure and chemotherapy with capecitabine thereafter. Aggravation of stiffness, rigidity, and low back pain was observed after the first chemotherapy cycle and capecitabine was discontinued. Furthermore, levodopa was slowly discontinued and low dose of diazepam was administered which resulted in partial resolution of the patient’s symptoms. Conclusion Paraneoplastic SPS is rare disorder with clinical features resembling those of parkinsonian syndrome and making the correct diagnosis remains a challenge. The diagnosis of parkinsonian syndrome should be re-examined if subsequent examinations discover an associated malignant process. Although it remains unclear whether the patients with history of SPS are at the greater risk for symptoms deterioration after administration of capecitabine, clinicians should be aware of capecitabine side effects because recognition and appropriate management can prevent serious adverse outcomes.

2013-01-01

127

Aggressive angiomyxoma of vulva.  

PubMed

A lady of 44 years presented with progressively growing non-tender mass in the right labia majora over a period of one year. Ultrasound showed large perineal mass with predominantly echogenic low resistance type of arterial blood flow at different places on ultrasound. CT scan showed well-defined margins with attenuation less than that of muscle. MRI showed high signal intensity related to loose myxoid matrix and high water content of angiomyxoma. PMID:23823959

Bakhtiar, Umber Jalil; Awan, Azra Saeed

2013-07-01

128

Cancer of the Vulva  

MedlinePLUS

... 1975-2011 Browse the Tables and Figures Access CSR Contents in PDF Generate Custom Reports About the ... Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/ , based on November 2013 SEER data ...

129

Nodal Melanoma Metastasis under Infliximab Therapy in a Patient with Nevoid Melanoma First Misdiagnosed as Benign Nevus: A Potentially Dangerous Diagnostic Pitfall in the Era of Biologic Therapies  

PubMed Central

We report the case of a 53-year-old Caucasian woman who developed nodal melanoma metastasis under infliximab therapy 2 years after the removal of a nevoid melanoma, which was initially misdiagnosed as a benign compound nevus. This case illustrates the potential link between tumor necrosis factor (TNF)-? inhibition and the reactivation of latent melanoma. Furthermore, this case highlights the need for a complete skin examination before using anti-TNF-? therapy to rule out atypical malignant lesions or melanomas that can easily be missed because of presentations such as nevoid melanoma.

Safa, Gilles; Fromentoux, Sophie; Darrieux, Laure; Hogenhuis, Jean-Anastase; Tisseau, Laurent

2013-01-01

130

Langerhans cell histiocytosis misdiagnosed as liver cancer and pituitary tumor in an adult: A case report and brief review of the literature  

PubMed Central

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder in which pathological Langerhans cells accumulate in a variety of organs. LCH usually affects the bone, skin and lymph nodes of children; however, LCH occasionally affects vital organs, including the liver, spleen and pituitary gland. The present study reports a case of an adult LCH patient with marked liver damage, splenomegaly and pituitary damage treated using a new therapeutic strategy. This case was misdiagnosed as liver cancer and pituitary tumor on the basis of abdominal ultrasound, abdominal magnetic resonance imaging (MRI) and head MRI. The final diagnosis was established by identifying the proliferation of cluster of differentiation 1a-positive LCs in liver tissues. A new regimen of combined 12-week therapy of prednisolone/desmopressin/vincristine and 10 months of maintenance therapy of prednisolone/vinblastine/6-mercaptopurine improved symptoms, liver function and blood cell tests.

MA, JING; JIANG, YONGFANG; CHEN, XIANGYU; GONG, GUOZHONG

2014-01-01

131

Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature  

PubMed Central

Purpose To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). Case presentation In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease. After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. Conclusion GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate.

2014-01-01

132

Disseminated sparganosis in a cynomolgus macaque (Macaca fascicularis).  

PubMed

An adult male cynomolgus macaque (Macaca fascicularis) from Mauritius arrived at our facility in France after a 1-year period of quarantine in Spain. Clinical examination soon after arrival revealed the presence of numerous firm cutaneous and subcutaneous nodules (0.1-0.5 cm diameter) in the scrotal and inguinal areas, and persistent mild eosinophilia. On necropsy examination additional similar nodules were found in the peritoneum and abdominal wall, omentum and mesentery. Microscopical examination revealed disseminated eosinophilic granulomas containing tapeworm larvae identified as Spirometra erinaceieuropaei by direct sequencing of the cox1 gene. PMID:23039991

Bauchet, A-L; Joubert, C; Helies, J-M; Lacour, S A; Bosquet, N; Le Grand, R; Guillot, J; Lachapelle, F

2013-05-01

133

Localized mastocytosis of the vulva.  

PubMed

Mastocytosis is a relatively common disorder characterized by mast cell collections in the skin and other organ systems. Affected children are more likely than adults to have limited cutaneous disease. We report two patients with localized vulvar mastocytosis in the absence of other cutaneous findings and review previous reports of vulvar involvement in cutaneous mastocytosis. PMID:24266857

Berry, Tammy; Strand, Megan; Smidt, Aimee C; Torrelo, Antonio

2014-01-01

134

Löfgren's syndrome misdiagnosed as cellulitis.  

PubMed

Löfgren's syndrome is an acute-onset presentation of sarcoidosis that can be easily missed in an ED setting. A case is reported of Löfgren's syndrome presenting as erythema nodosum with bilateral ankle oedema. Although rare, this diagnosis should be considered when examining a patient with erythema nodosum and articular symptoms. PMID:21668726

Cheng, Daryl Ray; Maini, Amit

2011-06-01

135

Three-Day Combination Treatment for Vulvovaginal Candidosis with 200 mg Clotrimazol Vaginal Suppositories and Clotrimazol Cream for the Vulva is Significantly Better than Treatment with Vaginal Suppositories Alone - an Earlier, Multi-Centre, Placebo-Controlled Double Blind Study  

PubMed Central

Problem: According to the guidelines, acute vulvovaginal candidosis (VVC) may be treated vaginally, through a combination of vaginal treatment and cream for the vulva or orally. However, there is a lack of investigations into whether combined treatment for the vagina and vulva achieves better results than vaginal treatment alone. Method: In 1999, 160 patients with vulvovaginal candidosis from ten German gynaecological practices were included in a study and treated on a randomised basis with three 200?mg clotrimazol vaginal suppositories?=?clotrimazol 2?% cream (verum n?=?79) or + placebo (active-ingredient-free cream base n?=?79). The examinations took place before treatment (T1), six to eight days following the end of treatment (T2) and approximately four weeks following the end of treatment (T3). In addition to demographic data, the clinical findings of each investigation were documented in a standardised way and a native preparation and a fungal culture were taken. The doctor and patient evaluated the healing process and tolerance. The main efficacy variables were the pre/post difference scores for extravaginal redness. Results: On T1, there was no difference between the two groups. By T2, there was a significant difference in the extent of extravaginal redness between the verum and the placebo groups (p?=?0.0002), as well as in the subgroup of the per-protocol analysis (verum 64, placebo 70 patients, p?=?0.0015). Genital itching or burning had entirely disappeared in 51?% and 56?% of patients respectively in the verum group and in only 30?% and 45?% of patients in the placebo group on T2 (p?=?0.0181). There was no difference in intravaginal redness on T1 and T2 in either group. The overall assessment by the doctor went accordingly (p?=?0.0004). On T1, the extravaginal fungal culture was positive in 75 women in the verum group and in 76 women in the placebo group. On T2, however, this was positive in 51.9?% (verum) and 73.1?% (placebo) of cases, and a positive culture was evinced in the vagina in 6 vs. 8 women (7.5 vs. 10.1?%, p?=?0.3802). The local tolerance in both groups was 70?% very good, and 29 vs. 27?% good. After four weeks (T3), 16 out of 23 patients in the verum group and only 8 out of 21 in the placebo group had negative extravaginal fungal cultures. Discussion: There is a lack of studies into the issue of whether vaginal treatment or combined vulvovaginal treatment of acute VVC would be more advantageous. However, there are two studies that support the significant results of this paper that when it comes to acute VVC, the combination of three 200?mg clotrimazol vaginal suppositories with clotrimazol cream 2?% is better than with vaginal suppositories alone.

Mendling, W.; Schlegelmilch, R.

2014-01-01

136

Idiopathic Calcinosis Cutis of the Vulva  

PubMed Central

Background: In the present study, calcinosis cutis (CC) is defined as the deposition of amorphous calcium and phosphate salts under epidermis and it may be caused by a pre-existing event such as extravasation injury or hypercalcemic conditions. Idiopathic CC cases have no underlying disease or pre-existing cause. Aim: A demostrative vulvar idiopathic CC case presentation and review of the related literature. Methods: A 42-year-old multiparous female presented with vulvar nodular masses. She was keen on surgical removal of the lesions, as the masses caused dyscomfort during sexual intercourse. The lesions were removed and sent for histopathological examination. There was neither a history of trauma nor any inflammatory process in the vulvar skin prior to the development of lesions and no systemic abnormality was detected. Results and Conclusions: The histhopathologic evaluation of the biopsy specimen showed amorphous calcium deposits without any inflammatory infiltration in the dermis. There was no recurrence at 1 year's follow-up. This case shows that idiopathic CC may develop slowly at labio-vulvar region in a sexually active female with normal systemic or laboratory findings

Coban, Yusuf K; Aytekin, Ahmet H; Aydin, Engin N

2013-01-01

137

[Angiomiofibroblastoma of the vulva. Report of case].  

PubMed

Angiomyofibroblastoma is a benign mesenchymal tumor of the lower genital tract described in 1992 by Fletcher and his group. Must be differentiated mainly from aggressive angiomyxoma, which has a high local recurrence rate. We report the case of a 21 year old patient who attended the General Hospital Dr. Miguel Silva, in Morelia, Michoacan, because post-term pregnancy of 41.1 weeks gestation, with a bulky vulvar tumor, asymptomatic with four years of evolution. Cesarean section and vulvar tumor resection were performed. The surgical specimen measured 14 x 10 x 5 cm, had a polypoid aspect, multilobulated, with nodules of varying size. From a microscopic point of view the tumor was well defined, formed by loose connective tissue septa, with stromal fusiform cells and benign characteristics, between collagen fibers, with abundant vessels. The histochemical studies were positive for desmin and vimentin. These anatomopathological findings are diagnostic of vulvar angiomyofibroblastoma, benign course tumor, does not resort nor does it generate metastases after simple surgical resection; however, recurrence in the vagina is reported. Must be differentiated from other mesenchymal neoplasms of the genital tract. PMID:23837300

Pérez-Martínez, Andrés; Chávez-Martínez, Sareni; Sereno-Coló, José Antonio; Arias-González, María Leilanie

2013-06-01

138

Cerebral Vein Thrombosis Misdiagnosed and Mismanaged  

PubMed Central

Cerebral venous thrombosis (CVT) should be considered in the differential diagnosis of all unexplained CNS disorders of sudden onset. Etiological factors are often subclinical forms of several common thrombophilic states occurring together, rather than the typical inherited and rare causes. Diagnosis is missed because of the heterogeneity in clinical presentation and etiological factors. In several patients with the so called idiopathic CVT nutritional deficiencies and lifestyle issues are more important factors in pathogenesis, rather than single rarer causes. High index of suspicion is the key to diagnosis. Clinical skill has to be fine tuned to diagnose the problem and to identify all the etiological factors. Radiology is essential for diagnosis but relying on radiology alone will lead to missing several cases and even erroneous diagnosis. It is inappropriate to proceed prematurely to laboratory investigations, forgetting proper clinical evaluation by studying diet, lifestyle, and environment of the patients. Success in managing lies in identifying all the contributory causes and correcting all of them giving excellent outcome almost always. Clinical observations based on case series and sharing of such information alone are the means to arrive at a consensus in diagnosis and management.

Sasidharan, P. K.

2012-01-01

139

Status cataplecticus misdiagnosed as recurrent syncope.  

PubMed

A 76-year-old patient, since the age of 45, presented with frequent attacks often triggered by emotional stimuli and characterised by forward head drop and a fall to the ground without loss of consciousness. Clinically these episodes were misinterpreted as pseudoseizures and treated with clomipramine for more than 20 years. In spite of this chronic therapy, during the last year, the attacks presented with a daily recurrence and, moreover, after arbitrary clomipramine withdrawal, they increased in frequency until they became subcontinuous. Videopolygraphic analysis, multiple sleep latency test (MSLT) and human leukocyte antigen (HLA) association studies were suggestive of narcolepsy and the recurrent episodes, diagnosed as status cataplecticus, recovered after citalopram administration. PMID:18175082

Calabrò, R S; Savica, R; Laganà, A; Magaudda, A; Imbesi, D; Gallitto, G; La Spina, P; Musolino, R

2007-12-01

140

Accurately diagnosing commonly misdiagnosed circular rashes.  

PubMed

Rashes are common in the pediatric population yet can be quite problematic for nurse practitioners to diagnose. A thorough history and physical examination, along with some simple procedures, will aid in identifying these skin conditions. Four cases are presented, which may initially prove challenging to diagnose, and symptoms are categorically examined to arrive at the accurate diagnoses. Treatment guidelines, options, and the role of parental education and involvement also are discussed. PMID:17907732

Popovich, Debbie; McAlhany, Allison

2007-01-01

141

A Case of Sparganosis mansoni in the Thigh: Serological Validation of Cure Following Surgery  

PubMed Central

Cases of Sparganum mansoni, caused by the plerocercoid larva of the tapeworm S. mansoni, occur throughout the world, particularly in Asian, Middle Eastern, and European countries. However, cases of infection with this parasite are rarely seen in Japan. Here, we present a case of a 61-year-old woman with a solitary subcutaneous nodule in left inner aspect of the thigh, from which a long, slender, whitish worm was surgically removed. The parasite was histopathologically identified as S. mansoni. Serological testing confirmed cure of the infection after surgical removal of the parasite. The authors advocate immunoserological examination in case of S. mansoni.

Chiba, T; Yasukochi, Y; Moroi, Y; Furue, M

2012-01-01

142

Recurrent aggressive angiomyxoma of the vulva - a rare presentation.  

PubMed

We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its' recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date. PMID:24995218

Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Roy, Hironmoy; Sarkar, Amarendra Nath

2014-05-01

143

Mucormycosis of the vulva in an immunocompromised pediatric patient.  

PubMed

Primary cutaneous mucormycosis is very unusual and rarely reported in the literature. The diagnosis is difficult and may mimic several infectious and immunologic diseases. We report a case of vulvar mucormycosis in a pediatric patient with end stage renal disease. A female on her first decade of life presented with a small scar on the right labia majora that in matters of weeks progressed aggressively, ulcerated, extended to the contralateral labia and invaded the entir vulvar region. Subsequent surgical debridement was undertaken. Pathology revealed Mucor species with progressive tissue necrosis. The patient was successfully trea ed with systemic antifungal, wide debridement of the affected area, hyperbaric oxygen therapy and surgical reconstruction of the area PMID:23882994

Colón, Malieri; Romaguera, Josefina; Mendez, Keimary; Vilchez, Denise; Navas, Edward J; Perez, José

2013-01-01

144

Aggressive angiomyxoma of vulva recurring 8 years after initial diagnosis  

Microsoft Academic Search

Background  Aggressive angiomyxoma is an uncommon soft tissue tumor which preferentially involves pelvic and vulvoperineal regions of\\u000a young adult females. The typical characteristics include gelatinous appearance and locally infiltrative nature without evidence\\u000a of nuclear atypia or mitosis. Treatment involves surgery, but local recurrence is high in spite of apparently complete surgical\\u000a resection.\\u000a \\u000a \\u000a \\u000a Case  A 28-year-old woman who had had a history of

Mehmet Coskun Salman; Gamze Mocan Kuzey; Nasuh Utku Dogan; Kunter Yuce

2009-01-01

145

Aggressive angiomyxoma of the vulva: An uncommon entity  

PubMed Central

Aggressive angiomyxoma is a rare, locally invasive mesenchymal tumor occurring usually in women of reproductive age, which carries a high risk for local relapse; hence the need to differentiate it from the other mesenchymal tumors occurring in this region. We describe a case of a 44-year-old female presenting with a large pedunculated swelling on the right labia majora.

Kura, Mahendra M.; Jindal, Saurabh R.; Khemani, Usha N.

2012-01-01

146

Chronic Ulcerative Herpes Simplex Virus Infection of the Vulva  

PubMed Central

Herpes simplex virus infections in HIV-infected individuals can be clinically unusual and difficult to treat due to underlying problems with cell-mediated immunity and the occurrence of antiviral resistance. Additionally, partial or incomplete restoration of immune function may result in chronic ulcerations that require rotational treatments. In this report, we describe the case of a 38-year-old HIV-positive woman who developed the ulcerative form of chronic herpes simplex infection despite highly active antiretroviral therapy and valacyclovir prophylaxis. Repeated intravenous courses of foscarnet and topical cidofovir finally controlled her erosions as her cell-mediated immunity was slowly restored. This case highlights the challenges that still exist in diagnosing and managing this rare presentation of herpes simplex virus

Griffith-Bauer, Kelly; O'Hearn, Mary; Ehst, Benjamin D.

2012-01-01

147

IRRADIATION IN CARCINOMA OF THE VULVA: FACTORS AFFECTING OUTCOME  

Microsoft Academic Search

Purpose: This report reviews the increasing role of radiation therapy in the management of patients with histologically confirmed vulvar carcinoma, based on a retrospective analysis of 68 patients with primary disease (2 in situ and 66 invasive) and 18 patients with recurrent tumor treated with irradiation alone or combined with surgery. Methods and Materials: Of the patients with primary tumors,

CARLOS A. PEREZ; PERRY W. GRIGSBY; K. S. CLIFFORD CHAO; ANDREW GALAKATOS; MELAHAT GARIPAGAOGLU; DAVID MUTCH; MARY ANN LOCKETT

1998-01-01

148

Dermatofibrosarcoma protuberans of the vulva: a case report.  

PubMed

Dermatofibrosarcoma protuberans (DFSP) is a low-grade to intermediate-grade well-differentiated sarcoma of dermal origin. Local recurrence rates are high but distant metastases are rare. This report describes a case of vulvar DFSP requiring four resections for primary clearance. A 56-year-old woman referred after excision of a vulvar tumour and histology had DFSP extending to the resection margins. Two more extended excisions again yielded a specimen with positive margins. The last excision was performed with intraoperative frozen section analysis of the margins. Frozen section analysis of the resected specimen revealed clear margins and this was confirmed by final pathology. The postoperative course was uneventful. The patient has been without recurrence for 15 months. A wide and deep local excision is recommended for both primary and recurrent lesions. The patient had three resections before clear surgical margins were achieved. Intraoperative frozen section analysis is helpful in assessing resection margins. PMID:21686834

Oge, Tufan; Benedicic, Christoph; Tamussino, Karl; Regauer, Sigrid

2009-01-01

149

Aggressive rhabdomyosarcoma of the vulva in a young Sudanese woman.  

PubMed

A 22-year-old para 2, female presented with a 2-month history of a progressively vulvar mass. Clinically, her general condition was poor. She had bilateral inguinal lymphadenopathy. Local examination revealed a large deeply infiltrating vulvar mass. Pathological evaluation revealed pleomorphic rhabdomyosarcoma. PMID:17334481

Haroun, Siddig A; Elnaiem, Eltayeb A; Zaki, Zaki M S; Adam, Ishag

2007-03-01

150

Recurrent Aggressive Angiomyxoma of The Vulva - A Rare Presentation  

PubMed Central

We describe here a case of a 38-year-old lady presenting with a about 5x4cm in size swelling on the left labia majora. She had similar type of swelling 2 years back which was treated surgically. FNAC report of the present mass revealed angiomyxoma. In view of its’ recurrent nature wide local surgical excision of the mass was done. Histopathology report confirmed the diagnosis of angiomyxoma. The lady is under follow up and there is no further recurrence till date.

Sengupta, Sandip Kumar; Bhattacharyya, Sanjay Kumar; Saha, Shyama Prasad; Sarkar, Amarendra Nath

2014-01-01

151

Acral lentiginous melanoma misdiagnosed as tinea pedis: a case report.  

PubMed

The incidence of acral lentiginous melanoma (ALM) varies in different ethnic groups. Volar skin is a relatively infrequent site of malignant melanoma in Caucasian patients, although the foot is the most common site of involvement in Asian and African populations. Diagnosis of ALM is usually delayed and melanomas can be diagnosed at advanced clinical stages, so the prognosis is often poor. We present a Caucasian Turkish man with ALM on the interdigital site of his foot, however, as a result of maceration of the surrounding skin, it seemed to be tinea pedis. PMID:14693019

Serarslan, Gamze; Akçalý, Cenk; Atik, Esin

2004-01-01

152

Misdiagnosing the Problem: Mental Health Profiles of Incarcerated Juveniles  

Microsoft Academic Search

Aggression, antisocial and delinquent behavior frequently result in the incarceration of a large number of young people, but these problems pale in comparison to the mental health challenges faced by many of these youth. Recent studies show a high prevalence of mental disorders among adolescents within the justice system. These findings have led researchers, clinicians and policy-makers to re-evaluate the

Candice L. Odgers; Mandi L. Burnette; Preeti Chauhan; Marlene M. Moretti; N. Dickon Reppucci

153

Misdiagnosing the Problem: Mental Health Profiles of Incarcerated Juveniles  

PubMed Central

Aggression, antisocial and delinquent behavior frequently result in the incarceration of a large number of young people, but these problems pale in comparison to the mental health challenges faced by many of these youth. Recent studies show a high prevalence of mental disorders among adolescents within the justice system. These findings have led researchers, clinicians and policy-makers to re-evaluate the assessment and treatment options that are available for youth within correctional facilities. This article provides a concise review of the most recent research related to mental health disorders among incarcerated juveniles within Canada and the United States. Rates of some of the most common mental health disorders among juveniles, including depression, anxiety, attention deficit hyperactivity and substance use are summarized. Throughout the review, issues related to co-morbidity and gender differences are highlighted. The implications of mental health disorders for juvenile justice policy and practice are discussed.

Odgers, Candice L.; Burnette, Mandi L.; Chauhan, Preeti; Moretti, Marlene M.; Reppucci, N. Dickon

2005-01-01

154

Kirner's Deformity Misdiagnosed as Fracture: A Case Report  

PubMed Central

Kirner`s deformity or dystelephalangy is a rare entity which presents with painless, progressive, bilateral radiovolar curving of the terminal phalanges of the little fingers. It is a clinicoradiological diagnosis. Herein, we present a case where the patient was being treated as having a fracture of the distal phalanx because of misdiagnosis of Kirner`s deformity. Given the rarity of the deformity, we believe it useful to present our case report as a contribution to the literature.

Khalid, Saifullah; Khalid, Mohd; Zaheer, Samreen; Ahmad, Ibne; Ullah, Ekram

2012-01-01

155

Lacrimal dacryostenosis with severe facial pain misdiagnosed as trigeminal neuralgia.  

PubMed

A 47-year-old woman developed intermittent shooting pain around the right side of the nose and eyes. A neurologist initially diagnosed trigeminal neuralgia, but carbamazepine did not improve the pain. Two months later, she presented with a pus-like eye discharge and was referred to us for further examination. Poor saline irrigation from the lacrimal puncta and computed tomography findings of a swollen lacrimal sac indicated a diagnosis of lacrimal dacryostenosis. At this point, the pain and dizziness as a side effect of carbamazepine had become intolerable. Endoscopic intranasal dacryocystorhinostomy confirmed stenosis of the nasolachrymal duct and a thickened lacrimal sac. The postoperative course was uneventful, and the facial pain disappeared. This experience suggests the importance of recognizing lacrimal dacryostenosis as a differential diagnosis of facial pain around the eyes and nose. We also recommend a review of an original diagnosis of trigeminal neuralgia if carbamazepine fails to relieve facial pain. PMID:21571463

Tanigawa, Tohru; Sasaki, Hirokazu; Kaneda, Masahiro; Kuruma, Tessei; Ueda, Hiromi

2012-04-01

156

Susac's syndrome or retinocochleocerebral vasculopathy: a misdiagnosed and overlooked disorder.  

PubMed

We report a case of Susac's syndrome (retinocochleocerebral vasculopathy) that was initially successfully treated with steroids. The patient had a recurrence of the disorder 2 years after the onset of the first clinical manifestations; this was treated with steroids and both calcium channel blockers and aspirin. Our findings underline the importance of recognizing patients with retinocochleocerebral vasculopathy at an early stage so that it may be accurately managed and, therefore, result in both decreased morbidity and disability related to severe sequelae. We also stress the need for patients with Susac's syndrome to have both close and long-term follow-up in order to disclose both symptomatic and asymptomatic recurrences of the disorder. PMID:10745157

Marie; Guegan-Massardier; Levesque; Favennec; Cailleux; Courtois

2000-04-01

157

Ocular tuberculosis misdiagnosed as retinoblastoma: an interesting case  

PubMed Central

Tuberculosis is a ubiquitous disease and a public health problem of major importance in almost all developing and underdeveloped countries. It can involve any part of the body, including the eye. We report a case of a young child presenting with a painful blind eye with leucocoria, where a misdiagnosis of retinoblastoma was made clinically. The eye was enucleated, and subsequent pathological examination led to a final diagnosis of ocular tuberculosis. The patient was put on anti-tubercular treatment, and responded well.

Maheshwari, Veena; Alam, Kiran; Jain, Anshu; Prasad, Smriti; Ahmad, Shamshad; Amitava, A K

2009-01-01

158

Causes of imbalance and abnormal gait that may be misdiagnosed.  

PubMed

Disorders of gait and balance are common in medicine and often lead to referral for neurologic evaluation. Because the maintenance of balance and normal gait are mediated by complex neurologic pathways as well as musculoskeletal, metabolic, and behavioral considerations, the list of possible contributing causes is very large. Much of the time, the history and neurologic examination reveal the underlying cause or causes. There are instances, however, when there are limited neurologic findings, as well as no structural abnormalities on brain or spine magnetic resonance imaging studies to explain the imbalance or gait difficulty. In this article, selected disorders that may be overlooked in the neurologic examination and imaging studies are reviewed. Possible causes of imbalance include occult drug-induced ataxia, autoimmune ataxia, ataxia associated with tremor, bilateral vestibular hypofunction, and spastic or dystonic gait disorders with normal imaging. PMID:24057830

Shill, Holly A; Fife, Terry D

2013-07-01

159

A case of 3-methylglutaconic aciduria misdiagnosed as cerebral palsy.  

PubMed

3-Methylglutaconic aciduria is a rare hereditary metabolic disorder characterized by increased urinary excretion of 3-methylglutaconic and 3-methylglutaric acids. Four clinical forms are recognized. This study presents the case of a 5-year-old male with type IV 3-methylglutaconic aciduria, initially diagnosed as "static encephalopathy." The slow evolution and other clinical characteristics, together with cerebral magnetic resonance imaging (MRI) findings, eventually directed the diagnosis to organic aciduria that was confirmed by urine test. This study proposes that the clinical criteria for childhood cerebral palsy should be rigorously respected; neuroimaging studies, particularly MRI, should be conducted to confirm the diagnosis, especially in atypical cases. PMID:11118804

Pantaleoni, C; D'Arrigo, S; D'Incerti, L; Rimoldi, M; Riva, D

2000-11-01

160

Traumatic appendicitis misdiagnosed as a case of haemoperitoneum.  

PubMed

Acute appendicitis is one of the most common emergencies handled by a surgeon. Various aetiologies of acute appendicitis have been proposed but none have been proved. Trauma too has been proposed as a cause of acute appendicitis. Here we present a case of blunt trauma abdomen which was explored to rule out a perforation of hollow viscous organ and haemoperitoneum, but at the time of exploration a perforated appendicitis was found. The chronological order of events points towards blunt trauma as the probable cause of this appendicitis. This case also highlights the fact that even if trauma was not the cause of acute appendicitis, acute appendicitis should still be kept in the differential diagnosis of a patient presenting with pain in the right lower abdomen and a history of trauma. PMID:24759158

Ahmed, Syed Tausif; Ranjan, Rajeev; Saha, Subhendu Bikas; Singh, Balbodh

2014-01-01

161

A Case of Neuromyelitis Optica Misdiagnosed as Cervicogenic Headache  

PubMed Central

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system associated with longitudinally extensive myelitis and optic neuritis. It is characterized by relapses that lead to blindness and paralysis sequelaes. But, this is rare disease; therefore high clinical suspicion for a correct diagnosis and proper examinations are not easy. However, early diagnosis is essential to prevent sequelae. We report the case of NMO with headache. A 30-year male patient who suffered headache visited our pain clinic because of aggravated pain despite treatment. The cause of the pain was revealed as NMO by more detailed previous history and examination.

Choi, Soo Il; Lee, Yeon Ju; Kim, Do Wan

2014-01-01

162

Anti-NMDAR encephalitis misdiagnosed as Hashimoto's encephalopathy.  

PubMed

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a well-defined autoimmune disorder. Hashimoto's encephalopathy (HE) is a still controversial entity, lacking definite diagnostic criteria. We described a 14-year-old-girl presenting with a clinical picture consistent with the diagnosis of anti-NMDAR encephalitis, confirmed by NMDAR antibody testing. Four years earlier, she had presented a similar episode of acute encephalopathy diagnosed as HE. Anti-NMDAR encephalitis and HE share similar clinical features so that the differential diagnosis can be difficult if specific antibodies are not tested. The correct diagnosis of anti-NMDAR encephalitis is crucial to plan the appropriate management and follow-up, namely in term of oncological screening, since it can be paraneoplastic in origin. We suggest to re-evaluate the clinical history of all subjects with previous HE diagnosis in order to evaluate the possible diagnosis of anti-NMDAR encephalitis and plan the appropriate management of these patients. PMID:23953644

Mirabelli-Badenier, M; Biancheri, R; Morana, G; Fornarino, S; Siri, L; Celle, M E; Veneselli, E; Vincent, A; Gaggero, R; Mancardi, M M

2014-01-01

163

Congenital chloride diarrhea misdiagnosed as pseudo-Bartter syndrome.  

PubMed

Congenital chloride diarrhea (CCD) is a rare autosomal recessive disease which is characterized by intractable diarrhea of infancy, failure to thrive, high fecal chloride, hypochloremia, hypokalemia, hyponatremia and metabolic alkalosis. In this case report, we present the first female and the second official case of CCD in Iran. A 15-month-old girl referred to our hospital due to failure to thrive and poor feeding. She had normal kidneys, liver and spleen. Treating her with Shohl's solution, thiazide and zinc sulfate did not result in weight gain. Consequently, pseudo-Bartter syndrome was suspected, she was treated with intravenous (IV) therapy to which she responded dramatically. In addition, hypokalemia resolved quickly. Since this does not usually happen in patients with the pseudo-Bartter syndrome, stool tests were performed. Abnormal level of chloride in stool suggested CCD and she was thus treated with IV fluid replacement, Total parentral nutrition and high dose of oral omeprazole (3 mg/kg/day). She gained 1 kg of weight and is doing fine until present. CCD is a rare hereditary cause of intractable diarrhea of infancy. It should be considered in infants with unknown severe electrolyte disturbances. PMID:24381629

Saneian, Hossein; Bahraminia, Emad

2013-09-01

164

Peroneal neuropathy misdiagnosed as L5 radiculopathy: a case report  

PubMed Central

Objective The purpose of this case report is to describe a patient who presented with a case of peroneal neuropathy that was originally diagnosed and treated as a L5 radiculopathy. Clinical features A 53-year old female registered nurse presented to a private chiropractic practice with complaints of left lateral leg pain. Three months earlier she underwent elective left L5 decompression surgery without relief of symptoms. Intervention and outcome Lumbar spine MRI seven months prior to lumbar decompression surgery revealed left neural foraminal stenosis at L5-S1. The patient symptoms resolved after she stopped crossing her legs. Conclusion This report discusses a case of undiagnosed peroneal neuropathy that underwent lumbar decompression surgery for a L5 radiculopathy. This case study demonstrates the importance of a thorough clinical examination and decision making that ensures proper patient diagnosis and management.

2013-01-01

165

Melanocytoma of the ciliary body misdiagnosed as iridodialysis  

PubMed Central

A 62-year-old female presented to our institution with dimness of vision in her right eye. On examination, her best corrected visual acuity was 20/100 in the right eye. The intraocular pressures were 14 mmHg in both eyes. Slit-lamp examination revealed nuclear sclerotic cataracts bilaterally and iridodialysis in her right eye. Seven days after the first visit, cataract surgery was performed without any complications. One year later, she presented to our institution with acute visual loss and ocular pain in the right eye. Best corrected visual acuity of the right eye was light perception and the intraocular pressure was 44 mmHg. Slit-lamp examination revealed a ciliary body mass with widespread pigment dispersion in the anterior segment. Due to no useful vision and uncontrolled pain, enucleation of the right eye was performed. Histopathologic examination revealed a melanocytoma of the ciliary body.

Kim, Moosang; Lee, Seung-Jun

2014-01-01

166

Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain.  

PubMed Central

The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been avoided if awareness of these conditions had led to a correct diagnosis upon initial physical examination.

Arroyo, J. F.; Jolliet, P.; Junod, A. F.

1992-01-01

167

A case of congenital kyphosis misdiagnosed as cerebral palsy  

Microsoft Academic Search

Introduction  Congenital kyphosis is an uncommon spinal deformity that needs prompt recognition and early surgery due to its progressive\\u000a nature, which can lead to neurological compromise.\\u000a \\u000a \\u000a \\u000a Case report  An 11-year-old boy presented with deteriorating ambulatory function after bilateral Achilles tendon lengthening and calcaneal\\u000a osteotomies. He previously had a series of orthopedic surgeries of the lower extremities, having been diagnosed with spastic\\u000a diplegic

Se Hee Jung; Moon Suk Bang

2007-01-01

168

Case report of Darier disease localized to the vulva in a 5-year-old girl.  

PubMed

A 5-year-old girl with Darier disease had numerous verrucous papules coalescing into plaques on both labia majora of approximately one year's duration. She was diagnosed as having genital warts, raising the suspicion of sexual abuse. Subsequently, a biopsy specimen from one of the vulvar lesions revealed histologic characteristics consistent with a diagnosis of Darier disease. The case is unusual for the age of onset and the site of initial involvement, and stresses the importance of including acantholytic disorders such as Darier disease in the differential diagnosis of a child with clinically verrucous lesions. PMID:8346108

Salopek, T G; Krol, A; Jimbow, K

1993-06-01

169

Paget's disease of the vulva with bladder invasion: a case report.  

PubMed

Tumor excision and dermal-flap skin graft operations were performed on a 72-year-old woman diagnosed with extramammary Paget's disease at our hospital in August 2001. Paget cells were identified in the external urethral meatus even though nine local excisions of recurrent tumors had been performed. She was suffered from severe vesical pain from May 2007. Urine cytology was class V and physical examination revealed redness in external urethral meatus. Pelvic MRI did not show apparent lymph node swelling and the endoscopic multiple biopsies performed at multiple bladder mucosa and distal urethra. Pathological diagnosis of the endoscopic biopsy showed multiple Paget cells from urethra, posterior and bilateral lateral wall, and bladder neck. Because Paget's disease may infiltrate bladder mucosa and cause severe vesical pain due to bladder invasion, total cystorethrectomy, ileal conduit, and external skin excision were performed. Pathological findings were continuous infiltration of Paget cells from external urethral meatus to bladder mucosa. PMID:22113464

Inoue, Shogo; Shiina, Hiroaki; Igawa, Mikio

2012-05-01

170

Prognostic factors associated with local recurrence in squamous cell carcinoma of the vulva  

PubMed Central

Objective To analyze the prognostic factors related to the recurrence rate of vulvar cancer. Methods Retrospective study of 87 patients diagnosed of vulvar squamous cell carcinoma diagnosed at a tertiary hospital in Madrid between January 2000 and December 2010. Results The pathological mean tumor size was 35.1±22.8 mm, with stromal invasion of 7.7±6.6 mm. The mean free margin after surgery was 16.8±10.5 mm. Among all patients, 31 (35.6%) presented local recurrence (mean time 10 months; range, 1 to 114 months) and 7 (8%) had distant metastases (mean time, 5 months; range, 1 to 114 months). We found significant differences in the mean tumor size between patients who presented a relapse and those who did not (37.6±21.3 mm vs. 28.9±12.1 mm; p=0.05). Patients with free margins equal or less than 8 mm presented a relapse rate of 52.6% vs. 43.5% of those with free margin greater than 8 mm (p=0.50). However, with a cut-off of 15 mm, we observed a local recurrence rate of 55.6% vs. 34.5%, respectively (p=0.09). When the stromal invasion cut-off was >4 mm, local recurrence rate increased up to 52.9% compared to 37.5% when the stromal invasion was ?4 mm (p=0.20). Conclusion Tumor size, pathologic margin distance and stromal invasion seem to be the most important predictors of local vulvar recurrence. We consider the cut-off of 35 mm of tumor size, 15 mm tumor-free surgical margin and stromal invasion >4 mm, high risk predictors of local recurrence rate.

Iacoponi, Sara; Diestro, Maria Dolores; Hernandez, Alicia; De Santiago, Javier

2013-01-01

171

Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva  

PubMed Central

En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease.

DeSimone, Christopher P.; Elder, Jeffrey; van Nagell, John R.

2011-01-01

172

Endoscopic ultrasound localization of a solitary insulinoma of pancreatic tail misdiagnosed as epilepsy: case report.  

PubMed

A 17-year-old female patient with features of epilepsy was treated with valproic acid. Two years later, hypoglycemia and hyperinsulinemia appeared. Transabdominal ultrasonography, spiral computed tomography, and indium-111 Octreoscan were performed without positive results. Endoscopic ultrasonography identified an oval tumor in the pancreatic tail with a color Doppler hypervascular pattern. Surgical enucleation decreased levels of insulin and C-peptide within 20 min, and the patient became free of symptoms and medications. PMID:14753607

Muscatiello, N; Cuomo, R; Gentile, M; De Francesco, V; Stoppino, V; Contillo, A; Salcuni, A; Natale, C; Panella, C; Ierardi, E

2003-01-01

173

A Misdiagnosed Cause of Chronic Pelvic Pain: Abscess with Foreign Body.  

PubMed

Objective.? Chronic pelvic pain may present a diagnostic challenge. Setting.? Academic tertiary care center. Design.? Case report. Case Report.? A 46-year-old woman presented with pain on micturition and a 15-month history of right-sided pelvic pain aggravated by an abdominal massage. Her course and outcome, aided by use of computed tomography (CT) scan, is described, identifying a 6-cm, mass-like lesion in the right lower quadrant enclosing an ambiguous linear calcified lesion, which on laparotomy revealed a fish bone embedded in a section of the terminal ileum and the perivesical area. Conclusion.? Chronic pelvic pain refractory to treatment merits consideration of CT to examine for foreign body. PMID:21995334

Jo, Yun Sung; Lee, Gui Se Ra; Lee, Do Sang; Kim, Sa Jin

2011-10-13

174

[Paraganglioma of the glomus caroticum--a frequently misdiagnosed disease picture].  

PubMed

24 carotid body tumors in 21 patients (1970-1990) have been analysed retrospectively. These well vascularized tumors are growing slowly in the carotid bifurcation and often cause failures in diagnostic and therapeutical approach. 66% (14) have been operated on partially 2-3 times with wrong diagnosis (cervical gland, lateral cervical cyst a.o.) in other hospitals. It is important to come to an early diagnosis by the typical trias according to Fontaine and Kocher, by CT-scan and arteriography. The best method of operation is the so-called technique of transsection, which is also applicable in advanced tumor stage (type II-III acc. to Linder). In tumors, which are beyond radical operability, good cosmetic and functional results can be achieved by partial resection. PMID:1580092

Kogel, H; Vollmar, J F; Mohr, W; Bianchi, D

1992-01-01

175

A misdiagnosed keratoacanthoma turned out to be a metastatic parotid carcinoma  

PubMed Central

Summary Distinguishing keratoacanthoma from well-differentiated squamous-cell carcinoma is often difficult on account of the clinical and histopathological similarities between them. Since the outcome of treatment depends on identifying the correct diagnosis and having the correct treatment on time, it is essential to differentiate keratoacanthoma and squamous-cell carcinoma as soon and accurately as possible. A paradigmatic case is herein reported. An 85 year-old female underwent total parotidectomy and ipsilateral neck dissection due to the squamous-cell carcinoma of the parotid gland. The investigations, in order to determine whether the tumour was a metastatic or a primary one, led to a misdiagnosis. A prior skin lesion, which was excised over her left cheek one year ago in another clinic, was diagnosed as keratoacanthoma. However, the histopathological revision of the specimen revealed that the lesion was in fact a squamous-cell carcinoma. Thus the parotid tumour was accepted as metastatic squamous-cell carcinoma rather than primary squamous-cell carcinoma.

Tas, E; Birol Ugur, M; Gul, A; Cinar, F; Uzun, L; Dogan Gun, B

2010-01-01

176

Ependymoma misdiagnosed as tuberculoma, misguided by overemphasis on MR spectroscopy in endemic area.  

PubMed

Ependymomas and tuberculomas are common paediatric posterior fossa lesions in developing countries and may be confused with each other due to some overlapping features. The distinction is important as the treatment for each is entirely different. We have described three young children in whom clinical-radiological features and the lipid peak seen on MR spectroscopy suggested the diagnosis of posterior fossa tuberculomas. All of them were started on empirical anti-tuberculosis therapy (ATT). Increase in size/no response to anti-tuberculosis therapy was disregarded as a paradoxical response. Finally, with clinical-radiological signs worsening, surgical excision was undertaken. Histopathology revealed ependymoma in all three children. This report highlights the overdiagnosis of tuberculosis in endemic areas due to biased clinical approach compounded by false positive investigations. Tissue diagnosis, though difficult by minimally invasive methods, should be sought before initiating ATT. The attempts to establish a tissue diagnosis should be continued even after starting empirical therapy, rather than waiting for the response. PMID:23832450

Futane, Sameer; Salunke, Pravin; Sahoo, Sushant; Mulinani, Naveen; Vyas, Sameer

2013-10-01

177

Hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS): a misdiagnosed disease entity  

PubMed Central

Hereditary diffuse leukoencephalopathy with spheroids (HDLS) was originally described in a large Swedish pedigree. Since then, 22 reports describing a total of 13 kindred's and 11 sporadic cases have been published. Inheritance is autosomal dominant, albeit the gene is unknown. Here we report on the clinical findings, genealogical data, brain MRI data, and autopsy/biopsy findings of four probands from three independently ascertained novel families from Norway, Germany and US. We identified a 39-year-old female and her twin sister, a 52-year-old male and a 47-year-old male with progressive neurological illness characterized by personality changes, cognitive decline and motor impairments, such as gait problems, bradykinesia, tremor and rigidity. Brain MRI showed white matter abnormalities with frontal prominence. Brain biopsy/autopsies were consistent with HDLS. HDLS is an under-recognized disease and in reporting these cases, we aim to increase the awareness of the disorder. Due to varied and wide phenotypic presentations, which may imitate several neurodegenerative diseases, HDLS can be difficult to diagnose. Definitive diagnosis can be established only by direct brain tissue examination. Familiarity with the clinical presentation and typical neuroimaging findings may be helpful in narrowing the diagnosis.

Sundal, Christina; Lash, Jennifer; Aasly, Jan; ygarden, Sarka ?; Roeber, Sigrun; Kretzschman, Hans; Garbern, James Y.; Tselis, Alex; Rademakers, Rosa; Dickson, Dennis W.; Broderick, Daniel; Wszolek, Zbigniew K.

2011-01-01

178

Using hip measures to avoid misdiagnosing early rapid onset osteoarthritis for osteonecrosis.  

PubMed

In the early phases, subchondral insufficiency fractures and rapidly destructive osteoarthritis of the hip are often mistaken for osteonecrosis of the hip. Three hip measures were used comparing combined subchondral insufficiency fractures and rapidly destructive 18 osteoarthritis patients to 18 osteonecrosis patients. Due to the rarity of these conditions there was no statistical power. Initial diagnoses for the osteoarthritis patients were recorded. The osteoarthritis group had significantly higher means for Tönnis angle (P<0.001), lateral center edge angle (P=0.006), and acetabular extrusion index (P=0.014). Only 7 of the 18 patients were initially diagnosed without reservation as subchondral insufficiency fracture or rapidly destructive osteoarthritis. Using hip measures will reduce the misdiagnosis of rapid onset osteoarthritis of the hip for osteonecrosis. PMID:24360489

Nelson, Fred R T; Bhandarkar, Varun S; Woods, Tammy A

2014-06-01

179

Lupus Vulgaris Erythematoides: report of a patient initially misdiagnosed as dermatitis.  

PubMed

A small percentage of patients with tuberculosis present with cutaneous findings, which may be difficult to diagnose. We present a patient diagnosed with a rare, non-scarring form of cutaneous tuberculosis (CTB), classically termed as lupus vulgaris erythematoides. PMID:24011284

Vazquez-Lopez, Francisco; Fueyo-Casado, Alejandro; Gonzalez-Lara, Leire

2013-01-01

180

Non-erosive gastroesophageal reflux disease in a teenager misdiagnosed as anorexia nervosa.  

PubMed

A middle school girl started a diet; she developed an eating disorder, and was diagnosed with anorexia nervosa. Endoscopic examination revealed no esophagitis due to gastric reflux, but slackness was seen in the cardiac region. Multichannel intraluminal impedance pH monitoring revealed marked non-acidic reflux. On the basis of positive symptom index (SI) and symptom association probability (SAP) values, the patient was diagnosed with non-erosive gastroesophageal reflux. The patient was afraid to eat because of the reflux; therefore, laparoscopic reflux prevention surgery was performed. The symptoms completely disappeared after surgery, and normal oral ingestion was possible. PMID:24806234

Akimoto, Shunsuke; Yano, Fumiaki; Tsuboi, Kazuto; Hoshino, Masato; Omura, Nobuo; Yanaga, Katsuhiko

2014-05-01

181

A pedunculated left ventricular hemangioma initially misdiagnosed as thrombus in a woman with atypical chest pain  

Microsoft Academic Search

The incidence of cardiac masses increased as echocardiography is becoming increasingly popular. Benign tumors of the heart\\u000a constitute about 72% of all primary cardiac neoplasms and hemangioma accounts for 5–10% of benign cardiac tumors. Cardiac\\u000a hemangiomas are generally asymptomatic and diagnosed incidentally during echocardiography or magnetic resonance imaging (MRI).\\u000a We reported a 52-year-old woman presented with atypical chest pain and

M. Azra Tanrikulu; Beste Ozben; A. Altug Cincin; Ozdil Baskan; Mehmet Agirbasli

2009-01-01

182

Phantom tumour of the lung in a patient with renal failure misdiagnosed as chest infection.  

PubMed

Phantom or vanishing tumour of the lung is a rare finding on chest radiographs that has been reported secondary to heart failure or chronic kidney disease. It has been described as an interlobular effusion of the transverse or oblique fissure of the right lung. Although it is uncommon, it should always be considered as a differential diagnosis for a radiographic opacity of the right-middle lung zone because it can be easily mistaken for a lung mass or infiltration. We herein present a case involving a patient with chronic kidney disease and a radiographic opacity of the right-middle lung that was diagnosed as a chest infection. The patient did not respond to various antibiotics and showed a poor response to diuretics, the standard treatment for phantom tumour. However, the patient markedly improved after dialysis, and the radiographic chest opacity disappeared. PMID:24943144

Althomali, Sarah Ali; Almalki, Mazen Mohammed; Mohiuddin, Syed Atif

2014-01-01

183

Multiple misdiagnoses of tuberculosis resulting from laboratory error--Wisconsin, 1996.  

PubMed

A positive culture for Mycobacterium tuberculosis confirms a diagnosis of tuberculosis disease (TB); however, false-positive cultures have resulted from laboratory error. In 1996, the Division of Health (DOH), Wisconsin Department of Health and Family Services, became aware of five possible incidents of laboratory error associated with the processing of M. tuberculosis cultures; these incidents resulted in the potential misdiagnosis of TB in 11 persons. This report summarizes the findings from the investigation of the five incidents, which suggest that four incidents were associated with cross-contamination of specimens in the laboratory and one with the inadvertent inoculation of a subculture from the incorrect broth medium; these errors resulted in adverse effects on patients and on the medical and public health systems. PMID:9285400

1997-08-29

184

Mesothelial Cyst of the Round Ligament Misdiagnosed as Irreducible Inguinal Hernia  

PubMed Central

We report the case of a 36-year-old woman who presented with signs and symptoms of an irreducible inguinal hernia. Surgical exploration revealed a mesothelial cyst of the round ligament of the uterus. Mesothelial cysts of the round ligament are rare lesions, frequently masquerading as inguinal hernias, and should be included in the differential diagnosis of any inguinal mass. Clinical findings are those of a groin mass, discomfort, and bulging. Ultrasound and CT scans often demonstrate an aperistaltic cystic mass. Definitive diagnosis is usually made intraoperatively and confirmed histopathologically.

Manatakis, Dimitrios K.; Stamos, Nikolaos; Agalianos, Christos; Vamvakas, Panagiotis; Kordelas, Athanasios; Davides, Demetrios

2013-01-01

185

Misdiagnosed male breast cancer with an unknown primary tumor: A case report  

PubMed Central

Compared with female breast cancer, male breast cancer (MBC) has an extremely low morbidity, later staging and fewer breast tissues. The lumps are easier to invade in the center and the majority of the cases are positive for metastatic lymph node, with the typical clinical manifestation as a painless mass in partial breast. MBC with an unknown primary tumor is rare and is often prone to misdiagnosis, resulting in a delay in correct treatment. Such a case is extremely significant for clinical reference. The current study presents a 58-year-old male who developed a painless mass in the left armpit and received armpit mass biopsy and pathological examination which showed glandular cancer, with a high possibility of mammary primary tumor. The patient was administered four cycles of paclitaxel plus oxaliplatin chemotherapy. However, three months later, the patient identified novel disseminated lymph nodes in the left armpit. The initial pathological section and paraffin blocks were re-examined and the patient was finally diagnosed with breast invasive ductal carcinoma based on the metastases pathology and immunohistochemical examination. No breast mass was found on physical examination of the patient and the tumor markers, including cancer antigen 125 and carcinoembryonic antigen, were normal. No primary tumors were observed in the mammography and PET-CT and the primary tumor was not found following the left breast modified radical mastectomy.

WANG, WEN-WU; CHEN, LANG; OUYANG, XUE-NONG

2014-01-01

186

Cellular schwannoma arising from the gastric wall misdiagnosed as a gastric stromal tumor: A case report  

PubMed Central

Cellular schwannomas have been previously described at almost every anatomic location of the human body, but reports in the gastric wall are rare. The current study presents a rare case of cellular schwannoma originating from the gastric wall. Computed tomography revealed a 5.6×5.3×4.0-cm3 solid mass located in the posterior wall of the stomach. Open laparotomy confirmed its mesenchymal origin. Microscopically, the tissue was composed of spindle-shaped and fascicularly-arranged cells, but mitotic figures were rare. Immunohistochemical staining showed that the tumor was negative for cluster of differentiation (CD)117, CD34, smooth muscle actin and desmin, but positive for S-100 and Ki67. The patient presented no evidence of recurrence and metastasis during follow-up. Gastric cellular schwannomas may be diagnosed by clinical characteristics, histological observations and immunohistochemical markers.

WANG, GUANGYAO; CHEN, PING; ZONG, LIANG; SHI, LEI; ZHAO, WEI

2014-01-01

187

Misdiagnosed Bipolar Disorder Reveals Itself to be Posttraumatic Stress Disorder with Comorbid Pseudotumor Cerebri  

PubMed Central

We present the case of a patient with a reported history of bipolar II and borderline personality disorders who presented to our inpatient psychiatry department following a suicidal gesture. We determined that she was not suffering from bipolar disorder at all, and we diagnosed her with posttraumatic stress disorder and pseudotumor cerebri. This paper describes the overlap of symptoms of bipolar disorder and posttraumatic stress disorder, which may lead to an incorrect diagnosis. Additionally, the patient had the complicating factor of comorbid pseudotumor cerebri, which we feel contributed to her psychiatric symptoms. Once the patient was properly diagnosed and placed on appropriate treatment, she responded well.

Salzbrenner, Stephen

2009-01-01

188

A Case of Intradural-Extramedullary Form of Primary Spinal Cysticercosis Misdiagnosed as an Arachnoid Cyst  

PubMed Central

We describe a rare case of intradural-extramedullary primary spinal cysticercosis. A 42-year-old man visited our institute for lower back pain. He denied having consumed raw meet. Magnetic resonance (MR) images revealed an intradural pure cystic mass at the L3-L4 level. A radiologic diagnosis of spinal arachnoid cyst was established. Three years later, he complained of aggravated back pain, and follow-up MR examination showed a markedly expanded cyst, occupying the subarachnoid space from the T11 to the S1 level. L2 hemilaminectomy was performed, and a yellowish infected cyst bulged out through the dural opening. The cyst was removed en bloc. The histopathological findings of the cyst were consistent with parasitic infection. Serum enzyme-linked immunosorbent assay (ELISA) confirmed the presence of spinal cysticercosis. As there was no intracranial lesion, the final diagnosis was primary spinal cysticercosis, which is very rare. MR imaging is a sensitive diagnostic tool for detecting cystic lesions in the spine; however, it is difficult to distinguish cysticercosis from non-infectious cysts such as an arachnoid cyst without using gadolinium enhancement. Clinicians treating spinal cysts with an unusual clinical course should include cysticercosis as a differential diagnosis. We recommend contrast-enhanced MR imaging and serum ELISA in the diagnostic work-up of such cases.

Yoo, Minwook; Lee, Chang-Hyun; Kim, Hyun-Jib

2014-01-01

189

Granuloma induced by sustained-release fluorouracil implants misdiagnosed as a hepatic tumor: A case report  

PubMed Central

Sustained-release fluorouracil (FU) implants have been extensively used in peritoneal interstitial chemotherapy, and during surgery for gastrointestinal tumors, breast cancer and hepatic tumors. Currently, studies regarding the complications associated with sustained-release FU implants are rare. The present study describes the case of a 61-year-old male who presented with a space-occupying lesion of the left lobe of the liver six months after undergoing a radical total gastrectomy. Thus, laparoscopic exploration was performed to remove the tumor. Postoperative histological examination demonstrated that the lesion in the left lobe comprised of necrotic tissue with granulation tissue hyperplasia. Based on the surgical and postoperative histological findings, the mass was proposed to be due to a high concentration of local sustained-release FU implants. Furthermore, the drug was partially surrounded and had been insufficiently metabolized over a long time period, which was proposed to have caused necrosis, proliferation and fibrillation, and induced granuloma. In conclusion, local high concentrations of sustained-release FU implants may be associated with granuloma and this finding may enable improved management of sustained-release FU implants during surgery.

BAI, DOU-SHENG; JIN, SHENG-JIE; HE, RONG; JIANG, GUO-QING; YAO, JIE

2014-01-01

190

A case of natural killer cell leukemia misdiagnosed as tuberculous lymphadenopathy.  

PubMed

Natural killer (NK) cell neoplasms are a group of rare but highly malignant tumors. We report here one case of NK cell leukemia. A 54-yr-old woman presented with a 2-month history of progressive left neck mass. Based on the positive result of tissue PCR for Mycobacterium tuberculosis, she was at first diagnosed with tuberculous lymphadenopathy. After two weeks, she developed generalized lymphadenopathy, hepatosplenomegaly, fever and anemia. Subsequent evaluation was performed including bone marrow aspiration and biopsy. Peripheral blood smear showed leukoerythroblastic features with 31% blasts. Bone marrow was packed with agranular blastoid cells, which were periodic acid-Schiff (PAS) positive and myeloperoxidase (MPO) negative. Immunophenotyping showed that these cells were positive for CD45 and HLA-DR, whereas negative for CD3, CD5, CD7, CD10, CD13, CD14, CD19, CD20, CD22, CD33, CD34, and CD61. Because of the absence of the markers of T-cell, B-cell, and myeloid lineage-specific antigens, we added CD16/56 for the immunophenotyping and the blasts were positive (94%). The tumor cells of biopsied lymph node were only positive for CD56, consistent with NK cell lymphoma. Epstein-Barr virus (EBV) was not detected by RNA in situ hybridization. Culture for M. tuberculosis was negative. Thus this patient was diagnosed with blastic NK cell lymphoma/leukemia involving bone marrow and lymph node. PMID:19571615

Lee, A Jin; Kim, Sang Gyung; Jeon, Chang Ho; Suh, Hun Suk; Yoon, Ghil Suk; Seo, An Na

2009-06-01

191

Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation  

PubMed Central

Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.

Kim, Ho-Su; Choi, Bong Hoi; Park, Jung Rang; Hahm, Jong Ryeal; Jung, Jung Hwa; Kim, Soo Kyoung; Kim, Sungsu; Kim, Kyong-Young; Chung, Soon Il

2013-01-01

192

A case of fascioscapulohumeral muscular dystrophy misdiagnosed as Becker's muscular dystrophy for 20 years.  

PubMed

A 60-year-old man diagnosed clinically with Becker's muscular dystrophy 20 years ago by another physician presented with gradually progressive proximal muscle weakness since teenage years. Family history revealed a strong paternal familial inheritance pattern of similar distribution of weakness-face, forearm flexion, knee extension and foot dorsiflexion. Work-ups revealed B12 deficiency and allele 1 deletion in fascioscapulohumeral muscular dystrophy (FSHD) DNA testing. FSHD is the third most common muscular dystrophy. Clinical diagnosis is made from the distinctive pattern of weakness, autosomal-dominant inheritance, and confirmed by genetic testing. This case strongly demonstrates the importance of a thorough and careful clinical evaluation even in a case with a long standing diagnosis. PMID:21795275

Ramos, Vesper Fe Marie Llaneza; Thaisetthawatkul, Pariwat

2012-03-01

193

Primary Malignant Fibrous Histiocytoma of the Chest Wall Misdiagnosed as Traumatic Hemothorax  

PubMed Central

Malignant fibrous histiocytoma (MFH), a type of sarcoma, is a malignant neoplasm with uncertain origins that arise from both the soft tissues and the bone. The occurrence of MFH on the chest wall is extremely rare. We hereby report a case of a 72-year-old woman who was incidentally detected with MFH after a traffic accident.

Hwang, Ki-Eun; Hwang, June-Seong; Kim, Kyung-Min; Jung, Jae-Wan; Oh, Su-Jin; Kim, Eun-Kyoung; Ryu, Dae-Woon; Choi, Keum-Ha; Jeong, Eun-Taik

2014-01-01

194

Child abuse and osteogenesis imperfecta: how can they be still misdiagnosed? A case report  

PubMed Central

Summary Osteogenesis imperfecta (OI) is a rare hereditary disease caused by mutations in genes coding for type I collagen, resulting in bone fragility. In literature are described forms lethal in perinatal period, forms which are moderate and slight forms where the only sign of disease is osteopenia. Child abuse is an important social and medical problem. Fractures are the second most common presentation after skin lesions and may present specific patterns. The differential diagnosis between slight-moderate forms of OI and child abuse could be very challenging especially when other signs typical of abuse are absent, since both could present with multiple fractures without reasonable explanations. We report a 20 months-old female with a history of 4 fractures occurred between the age of three and eighteen months, brought to authorities’ attention as a suspected child abuse. However when she came to our department physical examination, biochemical tests, total body X-ray and a molecular analysis of DNA led the diagnosis of OI. Thus, a treatment with bisphosphonate and a physical rehabilitation process, according to Vojta method, were started with improvement in bony mineralization, gross motor skills and absence of new fracture. In conclusion our case demonstrates how in any child presenting fractures efforts should be made to consider, besides child abuse, all the other hypothesis even the rarest as OI.

D'Eufemia, Patrizia; Palombaro, Marta; Lodato, Valentina; Zambrano, Anna; Celli, Mauro; Persiani, Pietro; De Bari, Maria Pia; Sangiorgi, Luca

2012-01-01

195

Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease  

PubMed Central

We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures.

Nett, Randall J.; Book, Earl; Anderson, Alicia D.

2012-01-01

196

IgG4-related sclerosing disease: an emerging entity frequently misdiagnosed.  

PubMed

IgG4-related sclerosing disease, a multiorgan system disease that has been identified in the last 10 years, is a fibroinflammatory condition with a marked propensity to manifest itself as mass forming lesions characterized by three main histological features (sclerosis, obliterative phlebitis and lymphoplasmacytic infiltrate) and by the presence of abundant IgG4+ plasma cells, frequent elevation of serum IgG4 and a dramatic initial response to steroid therapy. The aim of this mini-review is to increase the capacity to identify the characteristic features of IgG4-related sclerosing disease in specific organs and in two newly proposed entities (urethral caruncle and paratesticular fibrous pseudotumor) using biopsy specimens and methods of counting IgG4. In addition we examine the relationship between IgG4-related sclerosing disease and malignancy. In fact, an increased ability to recognize the characteristic features of IgG4-related sclerosing disease would play an extremely important role in avoiding unnecessary surgery in favor of initiating corticosteroid therapy. PMID:24341121

Mazzucchelli, Roberta; Racchini, Stefano; Barbisan, Francesca; Galosi, Andrea B; Giorgini, Sara

2013-08-01

197

"Why do I always see double?" A misdiagnosed case of ocular myasthenia gravis for 10 years.  

PubMed

A 58-year-old man presented with diplopia and partial ptosis for 10 years. It was non-progressive in nature, despite inadequate medical attention the patient received from non-specialists/general practitioners. He did not have fatigability or diurnal variation in weakness and was clinically stable without exacerbations of disease for a decade. He did not have features of Graves's disease, oculopharyngeal dystrophy, cranial nerve paralysis, polymyositis and stroke. The possibility of an atypical presentation of myasthenia gravis (MG) was considered and the patient was evaluated. Ice pack test was negative, Cogan's lid twitch (CLT) test was positive and high titres of acetylcholine receptor antibodies (AChR Ab) suggestive of MG were found. He was treated accordingly with a very good response. PMID:24792021

Yousuf, Uduman Ali Mohamed; Yashodhara, B M; Thanigasalam, Thevi; Ting, Heng Siang

2014-01-01

198

Epilepsy Misdiagnosed as Long QT Syndrome: It Can Go Both Ways.  

PubMed

Cardiogenic seizures are common and could be the sentinel event heralding the presence of congenital long QT syndrome (LQTS). Distinguishing a cardiogenic seizure from a neurogenic one is of the utmost importance. Herein, we present the case of a 12-year-old boy with recurrent episodes of syncope and seizures. Despite absence of QT prolongation on electrocardiogram, absence of documented arrhythmias, a negative LQTS genetic test, and recurrent episodes while on nadolol beta-blocker therapy, he was diagnosed with LQTS and implanted with an implantable cardioverter defibrillator (ICD). When syncope and seizure occurred with normal sinus rhythm documented on the ICD, he was referred to neurology, and an electroencephalogram was positive for numerous bursts of bilaterally synchronous generalized discharges. He was started on antiepileptic treatment after which his seizures resolved. His LQTS diagnosis was removed, beta-blocker therapy discontinued, and his ICD was explanted. He has been seizure-free for over 2 years. PMID:23750755

Medford, Beth A; Bos, J Martijn; Ackerman, Michael J

2013-06-10

199

Is Bilateral Lymphadenectomy For Midline Squamous Carcinoma Of The Vulva Always Necessary? An Analysis From Gynecologic Oncology Group (GOG) 173  

PubMed Central

Objective To determine which patients with near midline lesions may safely undergo unilateral groin dissection based on clinical exam and lymphoscintigraphy (LSG) results. Methods Patients participating in GOG-173 underwent sentinel lymph node (SLN) localization with blue dye, and radiocolloid with optional LSG before definitive inguinal-femoral lymphadenectomy (LND). This analysis interrogates the reliability of LSG alone relative to primary tumor location in those patients who had an interpretable LSG and at least one SLN identified. Primary tumor location was categorized as lateral (>2 cm from midline), midline, or lateral ambiguous (LA) if located within 2 cm., but not involving the midline. Results Two-hundred-thirty-four patients met eligibility criteria. Sixty-four had lateral lesions, and underwent unilateral LND. All patients with LA (N=65) and midline (N=105) tumors underwent bilateral LND. Bilateral drainage by LSG was identified in 14/64 (22%) patients with lateral tumors, 38/65 (58%) with LA tumors and in 73/105 (70%) with midline tumors. At mapping, no SLNs were found in contralateral groins among those patients with LA and midline tumors who had unilateral-only LSGs. However, in these patients groin metastases were found in 4/32 patients with midline tumors undergoing contralateral dissection; none were found in 27 patients with LA tumors. Conclusion The likelihood of detectable bilateral drainage using preoperative LSG decreases as a function of distance from midline. Patients with LA primaries and unilateral drainage on LSG may safely undergo unilateral SLN.

Coleman, Robert L.; Ali, Shamshad; Levenback, Charles F.; Gold, Michael A.; Fowler, Jeffrey M.; Judson, Patricia L.; Bell, Maria C.; De Geest, Koen; Spirtos, Nick M.; Potkul, Ronald K.; Leitao, Mario M.; Bakkum-Gamez, Jamie N.; Rossi, Emma C.; Lentz, Samuel S.; Burke, James J.; Van Le, Linda; Trimble, Cornelia L.

2013-01-01

200

Premalignant epithelial disorders of the vulva: squamous vulvar intraepithelial neoplasia, vulvar Paget's disease and melanoma in situ.  

PubMed

No standard screening programs exist to detect vulvar carcinoma or its precursor lesions, and therefore gynecologists, dermatologists and other healthcare providers in this field should be aware of the clinical features, behavior and management of the different existing premalignant vulvar lesions, squamous vulvar intraepithelial neoplasia (VIN), vulvar Paget's disease and melanoma in situ. In 2004, a new classification for squamous VIN was introduced by the International Society for the Study of Vulvar Disease, subdividing squamous VIN into the HPV-related usual type, and into differentiated type, which is associated with lichen sclerosus. This review describes the relevant aspects of squamous VIN, vulvar Paget's disease and melanoma in situ, its epidemiological characteristics, diagnosis, management and malignant potential. PMID:20504079

Terlou, Annelinde; Blok, Leen J; Helmerhorst, Theo J M; van Beurden, Marc

2010-06-01

201

Primary metastasized extraskeletal Ewing sarcoma of the vulva: report of a case and review of the literature  

Microsoft Academic Search

Purpose  Ewing’s sarcoma (ES) and primitive neuroectodermal tumor (PNET) are closely related malignant neoplasms, usually affecting\\u000a the skeletal system. Extraosseous ES\\/PNETs are uncommon, with occasional reports of tumors affecting the genitourinary tract.\\u000a Only few cases of primary vulvar Ewing’s sarcoma\\/PNET have previously been reported.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We present a patient with primary vulvar Ewing's sarcoma with pulmonary metastasis who presented at the Department

Katharina Kelling; Frank Noack; Christopher Altgassen; Peter Kujath; Michael K. Bohlmann; Friederike Hoellen

202

Absence seizures associated with panic attacks initially misdiagnosed as temporal lobe epilepsy: the importance of prolonged EEG monitoring in diagnosis.  

PubMed Central

While temporal lobe epilepsy is often considered in the differential diagnosis of patients with anxiety or panic disorders, other types of epilepsy can confound the presentation or treatment of adults with panic disorders. The cases of two patients are presented who were initially thought to have temporal lobe epilepsy producing panic attacks, but who were subsequently found to have primary generalized seizures. The clinical implications are discussed.

McNamara, M E

1993-01-01

203

Misdiagnosed zoophile tinea faciei and tinea corporis effectively treated with isoconazole nitrate and diflucortolone valerate combination therapy.  

PubMed

There have been few published reports on the human transmission of Trichophyton mentagrophytes, a zoophilic fungus frequently occurring in pets. Here we report on 2 girls, living with a pet dwarf rabbit, who presented with inflammatory skin lesions positive for T. mentagrophytes and subsequently diagnosed as zoophile tinea faciei and tinea corporis. The patients were successfully treated with systemic terbinafine and 2-week therapy with Travocort cream containing isoconazole nitrate 1% and diflucortolone valerate 0.1%. PMID:23574022

Czaika, Viktor A

2013-05-01

204

Should Steroid Therapy Be Necessarily Needed for Autoimmune Pancreatitis Patients with Lesion Resected due to Misdiagnosed or Suspected Malignancy?  

PubMed

To explore whether steroid therapy should be needed for autoimmune pancreatitis patients after operation, eight AIP patients receiving operation were enrolled in this study from January 2007 to July 2013. All patients underwent liver function, CA19-9, and contrast-enhanced CT and/or MRI. Tests of IgG and IgG4 were performed in some patients. Tests of serum TB/DB, ? -GT, and ? -globulin were undergone during the perioperative period. Six cases receiving resection were pathologically confirmed as AIP patients and two were confirmed by intraoperative biopsy. For seven patients, TB/DB level was transiently elevated 1 day or 4 days after operation but dropped below preoperative levels or to normal levels 7 days after operation, and serum ? -GT level presented a downward trend. Serum ? -globulin level exhibited a downward trend among six AIP patients after resection, while an upward trend was found in another two AIP patients receiving internal drainage. Steroid therapy was not given to all six AIP patients until two of them showed new lines of evidence of residual or extrapancreatic AIP lesion after operation, while another two cases without resection received steroid medication. Steroid therapy might not be recommended unless there are new lines of evidence of residual extrapancreatic AIP lesions after resection. PMID:24578705

Wu, Wenchuan; Yao, Xiuzhong; Lin, Chao; Jin, Dayong; Wang, Dansong; Lou, Wenhui; Qin, Xinyu

2014-01-01

205

Should Steroid Therapy Be Necessarily Needed for Autoimmune Pancreatitis Patients with Lesion Resected due to Misdiagnosed or Suspected Malignancy?  

PubMed Central

To explore whether steroid therapy should be needed for autoimmune pancreatitis patients after operation, eight AIP patients receiving operation were enrolled in this study from January 2007 to July 2013. All patients underwent liver function, CA19-9, and contrast-enhanced CT and/or MRI. Tests of IgG and IgG4 were performed in some patients. Tests of serum TB/DB, ?-GT, and ?-globulin were undergone during the perioperative period. Six cases receiving resection were pathologically confirmed as AIP patients and two were confirmed by intraoperative biopsy. For seven patients, TB/DB level was transiently elevated 1 day or 4 days after operation but dropped below preoperative levels or to normal levels 7 days after operation, and serum ?-GT level presented a downward trend. Serum ?-globulin level exhibited a downward trend among six AIP patients after resection, while an upward trend was found in another two AIP patients receiving internal drainage. Steroid therapy was not given to all six AIP patients until two of them showed new lines of evidence of residual or extrapancreatic AIP lesion after operation, while another two cases without resection received steroid medication. Steroid therapy might not be recommended unless there are new lines of evidence of residual extrapancreatic AIP lesions after resection.

Wu, Wenchuan; Yao, Xiuzhong; Lin, Chao; Jin, Dayong; Wang, Dansong; Lou, Wenhui; Qin, Xinyu

2014-01-01

206

Systemic onset juvenile idiopathic arthritis with macrophage activation syndrome misdiagnosed as Kawasaki disease: case report and literature review.  

PubMed

Patients with systemic onset juvenile idiopathic arthritis (SoJIA) are rarely known to develop coronary artery dilatation. The American heart association (AHA) statement on evaluation of suspected Kawasaki disease (KD) would lead some SoJIA patients (particularly in the early stages of the disease) to be inaccurately classified as KD. In addition to the institution of inappropriate therapy with IVIG, misdiagnosis as KD can delay definitive treatment for these SoJIA patients who probably have a worse predicted outcome. We present a 6-year-old male patient with SoJIA who was initially classified as incomplete KD. The child developed life-threatening macrophage activation syndrome (MAS). Previous literature regarding coronary dilatation in SoJIA is also reviewed. PMID:21132551

Kumar, Sharath; Vaidyanathan, Balu; Gayathri, S; Rajam, L

2013-04-01

207

A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome  

PubMed Central

Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available.

Porter, J.; Al-Jarrah, Q.; Richardson, S.

2014-01-01

208

A case of femoral arteriovenous fistula causing high-output cardiac failure, originally misdiagnosed as chronic fatigue syndrome.  

PubMed

Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available. PMID:24959370

Porter, J; Al-Jarrah, Q; Richardson, S

2014-01-01

209

Unusual morphologic presentations of blastic plasmacytoid dendritic cell neoplasm: report of two cases misdiagnosed as melanoma and leprosy.  

PubMed

We present 2 cases of blastic plasmacytoid dendritic cell neoplasm (BPDCN) showing unusual histological features. One patient, a 73-year-old male, presented with a nonpruritic macular erythema of the skin on the anterior and posterior chest wall, the biopsy of which was originally diagnosed as malignant melanoma. The neoplastic cells were negative for S100 and HMB45 and strongly positive for CD45, CD4, CD56, and CD123. The final diagnosis was a BPDCN associated with abundant melanin pigment and numerous melanophages. The second patient was a 73-year-old male with a 5-month history of small, slowly enlarging, bruise-like plaques on his limbs and chest. Histologic examination of the skin biopsy revealed an atypical cellular/myxoid infiltrate with numerous macrophages, which was originally diagnosed as consistent with lepromatous leprosy. The atypical cells were immersed in an alcian blue-positive myxoid matrix at pH 2.5. The Fite-Faraco stain was negative. Positive immunoreactivity was demonstrated for CD4, CD56, and CD123. Based on the histopathology and immunohistochemistry findings, a diagnosis of BPDCN with prominent myxoid matrix was rendered. PMID:23515558

León-Martínez, Grettel; Meillón-García, Luis; Morales-Polanco, Manuel; Soler-Montecinos, Lorenzo; Ortiz-Hidalgo, Carlos

2014-02-01

210

Misdiagnosed pneumothorax interpreted as necrotizing fasciitis of the chest wall: case report of a potentially preventable death  

PubMed Central

Background Subcutaneous emphysema is an uncommon clinical finding associated both with benign sources and potentially deadly necrotizing infections. Wide ranges of causes exist including trauma, iatrogenic injuries, factitious disorders and necrotizing infections. Case presentation A 49-year old male presented to the emergency room with extensive subcutaneous emphysema following blunt trauma. The orthopaedic surgery service was consulted for treatment of suspected necrotizing fasciitis due to his subcutaneous emphysema. A careful patient history and physical examination correlated with laboratory and radiographic findings revealed rib fractures and a long-standing, undiagnosed pneumothorax as the cause for emphysema. Treatment of the underlying condition with chest tubes led to eventual resolution of the emphysema, though multisystem organ failure ultimately resulted in patient death. Conclusion This case illustrates the importance of rapidly and appropriately evaluating trauma patients, and in this case specifically diagnosing and treating the underlying cause of subcutaneous emphysema. The late diagnosis of pneumothorax resulted in delayed definitive treatment, which may have contributed to the patient’s ultimate demise. In acute and sub-acute trauma situations a high level of suspicion for life threatening injuries must be maintained. Decision making for initial treatment should be based on the basic tenants of Advanced Trauma Life Support to primarily address these injuries and help prevent further disability or death.

2014-01-01

211

CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions  

Microsoft Academic Search

The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at

Eric J. Sacknoff; Jay Schweitzer; Michael Slatkine; Douglass S. Mead

1995-01-01

212

Challenging the concept of microinvasive carcinoma of the vulva: report of a case with regional lymph node recurrence and review of the literature  

Microsoft Academic Search

BACKGROUND: It is widely accepted that vulvar carcinoma with a depth of invasion of less than one millimeter is sufficiently treated by vulvectomy or wide local excision without inguinal lymphadenectomy. CASE PRESENTATION: However, a patient with inguinal lymph node recurrence 21 months after radical vulvectomy for stage IA squamous cell carcinoma was observed. CONCLUSION: According to a review of the

Jutta Sidor; Raihana Diallo-Danebrock; Elke Eltze; Ralph J Lellé

2006-01-01

213

Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis.  

PubMed

This meta-analysis investigated human papillomavirus (HPV) prevalence in vulvar, vaginal and anal intraepithelial neoplasia (VIN, VAIN, AIN) grades 1-3 and carcinoma from 93 studies conducted in 4 continents and using PCR assays. Overall HPV prevalence was 67.8%, 85.3% and 40.4% among 90 VIN1, 1,061 VIN2/3 and 1,873 vulvar carcinomas; 100%, 90.1% and 69.9% among 107 VAIN1, 191 VAIN2/3 and 136 vaginal carcinomas; and 91.5%, 93.9% and 84.3% among 671 AIN1, 609 AIN2/3 and 955 anal carcinomas, respectively. HPV16 was found more frequently (>75%) and HPV18 less frequently (<10%) in HPV-positive vulvar, vaginal and anal carcinomas than in cervical carcinoma. HPV6 and 11 were common in VIN1 and AIN1, but not in VAIN1. HPV prevalence in vulvar carcinoma varied most by histological type (69.4% in warty-basaloid and 13.2% in keratinized type) and was also higher in women 60 years or younger and in studies carried out in North America. HPV prevalence in anal carcinoma was higher among women (90.8%) than men (74.9%), but no difference by gender emerged in North America. The majority of AIN2/3 derived from studies of HIV-positive individuals and/or men who have sex with men. Among AIN2/3, HIV infection was associated with higher HPV prevalence, more multiple-type infections and a relative under-representation of HPV16. In conclusion, approximately 40% of vulvar, 60% of vaginal and 80% of anal carcinoma may be avoided by prophylactic vaccines against HPV16/18. This proportion would be similar for the corresponding high-grade lesions of the vagina and anus, but higher for VIN2/3 (75%) than for vulvar carcinoma. PMID:19115209

De Vuyst, Hugo; Clifford, Gary M; Nascimento, Maria Claudia; Madeleine, Margaret M; Franceschi, Silvia

2009-04-01

214

A Composite Neoplastic Lesion of the Vulva With Mixed Features of Fibroadenoma and Hidradenoma Papilliferum Combined With Pseudoangiomatous Stromal Hyperplasia Containing Multinucleated Giant Cells.  

PubMed

: Anogenital mammary-like glands (AGMLG) are nowadays considered a normal component of the anogenital area. Lesions affecting AGMLG are similar to those seen in breast. We present a case of a complex neoplastic lesion of the AGMLG with mixed features of fibroadenoma and hidradenoma papilliferum combined with pseudoangiomatous stromal hyperplasia. Multinucleated cells were detected in the pseudoangiomatous stromal hyperplasia areas as seen in some patients with neurofibromatosis type 1. The neoplasm is similar to rare mammary composite neoplasms that feature simultaneously patterns of a fibroepithelial neoplasms and intraductal papilloma. PMID:23503319

Konstantinova, Anastasia M; Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

2013-03-14

215

Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities  

ERIC Educational Resources Information Center

Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

2013-01-01

216

Identification of three novel OA1 gene mutations identified in three families misdiagnosed with congenital nystagmus and carrier status determination by real-time quantitative PCR assay  

Microsoft Academic Search

BACKGROUND: X-linked ocular albinism type 1 (OA1) is caused by mutations in OA1 gene, which encodes a membrane glycoprotein localised to melanosomes. OA1 mainly affects pigment production in the eye, resulting in optic changes associated with albinism including hypopigmentation of the retina, nystagmus, strabismus, foveal hypoplasia, abnormal crossing of the optic fibers and reduced visual acuity. Affected Caucasian males usually

Valérie Faugère; Sylvie Tuffery-Giraud; Christian Hamel; Mireille Claustres

2003-01-01

217

[Severe recurrent intrahepatic cholestasis in systemic AL amyloidosis without obvious liver involvement: unexplained hepatic toxicity or a case of misdiagnosed liver amyloidosis?].  

PubMed

We report the case of a 50-year-old woman who was admitted to the hospital for acute abdominal pain with nephrotic proteinuria, rapidly progressive renal failure, and moderate anemia. Laboratory tests showed mild Bence Jones (?) proteinuria with negative serum immunofixation and a mild increase in ? free light chains. A bone marrow biopsy and a fat tissue aspirate showed multiple myeloma and amyloidosis. Because of the end-stage renal disease, the patient began regular dialysis treatment and was started on bortezomib 1.3 mg/m2 plus dexamethasone 40 mg on days 1, 4, 8 and 11 of 21-day cycles. Ten days later she complained of a new episode of abdominal pain with jaundice. A CT scan and an MRI scan ruled out all secondary causes of cholangitis including cancer. Acute intrahepatic cholestasis due to amyloid deposition was then hypothesized. After 4 well tolerated cycles of bortezomib and dexamethasone, blood tests showed a complete hematological response with full reversal of cholestasis. After three months, a new episode of abdominal pain occurred and this time the patient was operated on and found to have an intestinal volvulus. Because of the jaundice, a transjugular liver biopsy was performed showing no evidence of amyloid deposits. Two months later the patient died of septic shock. Although no autopsy was performed and the ultimate cause of the cholestasis could not be ascertained, amyloidosis remains the major culprit in this unfortunate case. PMID:22388910

Paudice, Nunzia; Farsetti, Silvia; Caroti, Leonardo; Bandini, Sandro; Ciuti, Gabriele; Tempestini, Alessio; Perfetto, Federico; Galli, Simone; Giabbani, Letizia; Caldini, Anna Lucia; Bergesio, Franco

2012-01-01

218

Why are recurrent cervical cancers of the pelvic stump misdiagnosed as interstitial cystitis?: The urologist's point of view based on a case report  

PubMed Central

A 50-year-old female who had undergone laparoscopic total hysterectomy at a local clinic owing to leiomyoma of the uterus was referred to our hospital after having dysuria, urgency, frequency, lower abdominal pain and right flank pain over several months. After routine examinations, cystoscopy, computed tomography and magnetic resonance imaging were performed, and non-ulcerative interstitial cystitis accompanied by postoperative fibrosis secondary to a previous surgery was suggested. Pentosan sulfuric polyester (Elmiron, Alza Pharmaceuticals, Mountain View, CA) reduced her severely debilitating symptoms and improved her quality of life. Both the hydronephrosis and the symptoms were relieved by ureteral stent insertion and percutaneous nephrostomy. However, a few days later, she presented with vaginal bleeding along with her previous symptoms, and punch biopsy of the vaginal stump resulted in a diagnosis of adenocarcinoma. Both ureterocutaneostomy with radical cystectomy and lower anterior resection for rectum invasion were conducted. After the slide review of the original specimen from the local clinic, she was diagnosed with recurrent cervical cancer of the vaginal stump.

Oh, Jin Kyu; Kim, Khae-Hawn

2013-01-01

219

Children with disabilities are often misdiagnosed initially and children with neuropsychiatric disorders are referred to adequate resources 30 months later than children with other disabilities.  

PubMed

Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with neuropsychiatric disorders without mental retardation were referred 30 months later than other children. Agreement between the referrer's identification of the main disability and the habilitation center's was low with Kappa coefficient 0.44. Whereby agreement on diagnosis between referrer and habilitation centers was low, earlier referral should be promoted. PMID:22798050

Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K

2013-03-01

220

Intradermal spitz nevi: a rare subtype of spitz nevi analyzed in a clinicopathologic study of 74 cases.  

PubMed

: Spitz nevi are acquired melanocytic lesions with a wide histomorphological spectrum; reliable distinction from spitzoid melanoma is often difficult. Misdiagnoses of benign spitzoid tumors as spitzoid melanomas and vice versa are attributable to a frequently disturbing morphology and inconsistent or poorly defined histological criteria for diagnosis. Many recognized histological variants of Spitz nevi have been described, including the intradermal Spitz. Histopathologic descriptions of intradermal Spitz nevi have been done in the past; however, large studies addressing their histological spectrum have been lacking. We have retrospectively assessed the morphological features in 74 cases of intradermal Spitz nevi, excluding tumors clearly defined as atypical Spitz nevi and Spitzoid melanomas, to further delineate their histological spectrum. The patients' ages ranged from 5 to 81 years (median: 27). Anatomic location included: the upper extremities (27 cases), followed by head and neck (22 cases), lower extremities (9 cases), back (8 cases), buttock (5 cases), chest (1 case), and vulva (1 case). In 1 case, the anatomic location of the lesion was not available. Different histological variants were observed including hyalinized, polypoid, desmoplastic, angiomatoid, and halo Spitz. Morphological features evaluated included symmetry (100%), cell type (epithelioid 42%, spindle 16%, mixed 42%), maturation (85%), pigmentation (26%), chronic inflammation (24%), and mitotic activity (38%). Mild atypia was seen in 36 cases (49%), moderate atypia was seen in 28 cases (38%), and severe atypia was seen in 10 cases (14%). Intradermal Spitz nevus is a distinctive type of Spitz nevus that sometimes can be difficult to define given the unusual features that these lesions can show; thus, strict application of well-defined histological criteria and awareness of their morphological spectrum will facilitate definitive diagnosis. PMID:24736667

Plaza, Jose A; De Stefano, Danielle; Suster, Saul; Prieto, Victor G; Kacerovska, Denisa; Michal, Michal; Sangueza, Martin; Kazakov, Dmitry V

2014-04-01

221

Immunoproteomic Analysis of the Excretory-Secretory Proteins from Spirometra mansoni Sparganum  

PubMed Central

Background Sparganosis is caused by the invasion of Spirometra sparganum into various tissues/organs. Subcutaneous sparganosis can be diagnosed by biopsy, while visceral/cerebral sparganosis is not easy to be diagnosed. The diagnosis depends largely on the detection of specific anti-sparganum antibodies. The specificity of the ELISA could be increased by using S. mansoni sparganum excretory–secretory (ES) antigens, but it also had the cross-reactions with sera of patients with cysticercosis or paragonimiasis. The aim of this study was to identify early specific diagnostic antigens in S. mansoni sparganum ES proteins. Methods The sparganum ES proteins were analyzed by two-dimensional electrophoresis (2-DE) and Western blot probed with early sera from infected mice at 14 days post-infection. The immunoreactive protein spots were characterized by MALDI-TOF/ TOF-MS. Results A total of approximately 149 proteins spots were detected with isoelectric point (pI) varying from 3 to 7.5 and molecular weight from 20 to 115 kDa and seven protein spots with molecular weight of 23-31 kDa were recognized by the infection sera. Three of seven spots were successfully identified and characterized as the same S. mansoni protein (cysteine protease), and the proteins of other 4 spots were not included in the databases. Conclusion The cysteine protease from S. mansoni ES proteins recognized by early infection sera might be the early diagnostic antigens for sparganosis.

HU, Dan Dan; CUI, Jing; WANG, Li; LIU, Li Na; WEI, Tong; WANG, Zhong Quan

2013-01-01

222

An exploration of the psychosocial effects that school-age children with Child Absence Epilepsy (CAE) experience when their condition is misdiagnosed as Attention Deficit-Hyperactivity Disorder (ADHD)  

Microsoft Academic Search

The purpose of this study is to provide an understanding of the psychosocial effects of the misdiagnosis on these children. To also publish data that is not available at this time, and offer findings that will create a foundation for further research. This study is to be conducted by a researcher who has experience working with adolescents and young adults

Martin Raffaele

223

Carcinoma epidermoide infiltrante de clítoris en paciente de 30 años, no ligado a infección por virus del papiloma humano  

Microsoft Academic Search

Invasive squamous cell carcinoma of the vulva is exceptional before the age of 40 years. We present a differentiated squamous carcinoma of the clitoris in a 30-year-old nulliparous woman who presented with vulvodynia for the past 2 years. On examination, a suspicious tumor was detected in the clitoris. Biopsy revealed an invasive squamous cell carcinoma of the vulva, stage Ia.

Carlos Amselem; Carmen Sala; Enric Genover; M. Teresa Fernández-Figueras; Lluís Puig

2010-01-01

224

[Vulval dermatitis: localized condition--serious problem].  

PubMed

An overview of the literature of the dermatitis of the vulva is presented. The etiology, epidemiology, clinical manifestations, diagnosis, pathological diagnosis, treatment, and prevention of contact, allergic-contact, atopic, and seborrheic dermatitis of the vulva are described in details. Lichen simplex chronicus is additionally described as complication of chronic itching dermatitis. PMID:23534270

Kozlovskaia, V V; Tikhonovskaia, I V

2012-01-01

225

Microinvasive Paget's disease  

Microsoft Academic Search

Background.Microinvasive squamous cell carcinoma of the vulva is defined as stromal invasion ?1 mm and is treated by wide local resection. Whether criteria for microinvasive squamous cell carcinoma can be applied to Paget's disease of the vulva is unknown because of the rarity of that disease.

Thomas Ewing; John Sawicki; Giuseppe Ciaravino; Gregory J. Rumore

2004-01-01

226

Glandular fever and pulmonary artery thrombosis in a paraplegic patient, who had undergone splenectomy for splenic trauma sustained along with spinal cord injury: misdiagnosed initially as urine infection and later as lymphoma when CT scan revealed enlarged lymph nodes: a case report  

PubMed Central

Background A 36-year-old male sustained fracture of first lumbar vertebra, splenic tear and paraplegia in a motorcycle accident in 2001; splenectomy was performed. Case presentation In 2008, he presented with temperature and feeling rough. With a diagnosis of urine infection, he was prescribed ciprofloxacin, followed by trimethoprim, amoxicillin, and gentamicin, as temperature did not subside. White cell count was 21.2 × 109/L; lymphocytes were 13.05 × 109/L (1.00 – 4.00). Therefore, computerised tomography (CT) of chest and abdomen was performed. Thrombus was present in pulmonary arteries bilaterally involving the lobar and segmental branches. Enlarged lymph nodes were seen in axillae, chest, abdomen and inguinal regions. Radiological diagnosis was lymphoma. Cell marker showed an excess of large granular lymphocytes and activated lymphocytes. The Glandular Fever Slide Test was positive. Subsequently, Paul Bunnell test was also positive. Epstein Barr virus serology was consistent with recent Epstein Barr virus infection. Antibiotic was omitted; enoxaparin was prescribed for pulmonary artery thrombosis. Conclusion Learning points from this case: (1) Although routine administration of antibiotic to a spinal cord injury patient with pyrexia may be acceptable in outpatient setting, other possibilities such as infection by multi-drug resistant organism, viral infection, venous or, arterial thrombosis should be considered if a patient does not respond promptly to antibacterial therapy. (2) When full blood count showed lymphocytosis (comprising > 50% of white blood cells) with atypical morphology, lymphocyte surface markers, Paul Bunnell test, and Epstein Barr virus serology should be performed. These tests would have led to a diagnosis of infectious mononucleosis, and abdominal imaging studies could have been avoided. (3) Lymphoid hyperplasia is the hallmark of infectious mononucleosis; therefore, we should have suspected glandular fever rather than lymphoma when CT scan revealed enlarged lymph nodes in abdomen, mediastinum, axillae and inguinal regions in this patient, who had lymphocytosis with atypical morphology. (4) A soft tissue mass, situated inferior to left hemidiaphragm in this asplenic patient, was misinterpreted as lymph nodes; review of CT led to the correct diagnosis of splenunculus. (5) Acute infection with Epstein Barr virus may lead to transient induction of anti-phospholipid antibodies, which can cause vascular thrombosis. (6) This case illustrates the value of reviewing test results and discussion with senior doctors, as these measures help to recognize medical errors and improve patient care.

2009-01-01

227

Vaginitis test - wet mount  

MedlinePLUS

... the provider can see inside. A sterile, moist cotton swab is gently inserted into the vagina to ... Eckert LO, Lentz GM. Infections of the lower and upper genital tracts: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lentz ...

228

Vulvodynia  

MedlinePLUS

... link in the menu on the left. Common Names Vulvodynia Vulvar pain (chronic pain or discomfort of the vulva) Medical or Scientific Names Vulvodynia Vulvar vestibulitis Last Updated Date: 04/03/ ...

229

Cold knife cone biopsy  

MedlinePLUS

Noller KL. Intraepithelial neoplasia of the lower genital tract (cervix, vulva): Etiology, screening, diagnostic techniques, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology . 5th ...

230

Vulvar Care  

MedlinePLUS

... A make up remover that contains mineral oil, petroleum jelly, and paraffi n also can be used ( ... washcloth and put it against your vulva. Refrigerated petroleum jelly (Vaseline) and cold plain yogurt put on ...

231

General Information about Vulvar Cancer  

MedlinePLUS

... lymph nodes may also be removed. Radical vulvectomy : Surgery to remove the entire vulva. Nearby lymph nodes are also removed. Pelvic exenteration : A surgical procedure to remove the lower colon , rectum , and bladder . The cervix , vagina , ovaries , and nearby ...

232

21 CFR 884.5390 - Perineal heater.  

Code of Federal Regulations, 2010 CFR

...surface of the perineum (the area between the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the vulvar orifice for obstetrical purposes). (b) Classification. Class II (performance...

2009-04-01

233

21 CFR 884.5390 - Perineal heater.  

Code of Federal Regulations, 2010 CFR

...surface of the perineum (the area between the vulva and the anus) and is used to soothe or to help heal the perineum after an episiotomy (incision of the vulvar orifice for obstetrical purposes). (b) Classification. Class II (performance...

2010-04-01

234

Vulvodynia  

MedlinePLUS

... this test, the health care provider uses a cotton swab to touch areas of the vulva and ... and products containing deodorants, perfumes, and dyes. Wear cotton underwear and switch to cotton menstrual products if ...

235

Magnetic resonance imaging of vaginal and vulval pathology  

Microsoft Academic Search

There are a number of conditions affecting the vagina and vulva that can be optimally assessed with the use of high-resolution\\u000a magnetic resonance imaging (MRI). This paper gives a suggested protocol for MRI technique and sequences for imaging the pelvis\\u000a and perineum and reviews the MRI appearances of many of the common pathologies affecting the vagina and vulva. Congenital\\u000a anomalies,

N. Griffin; L. A. Grant; E. Sala

2008-01-01

236

Public health significance of zoonotic tapeworms in Korea.  

PubMed

Through an epidemiological review on the zoonotic tapeworms in Korea, the frequency and severity of the zoonoses have been recognized. Taeniasis and human cysticercosis are of importance to the public health in Korea. The frequency of taeniasis is 0.3% to 12.7% discovered by stool examination and 4.5% to 38.0% discovered by questionaire survey. Taeniasis occurs more frequently in males than in females and, especially, in both sexes in the age-group of 20 to 49. T. saginata is more common that T. solium. No case of human cysticercosis caused by T.saginata has been reported in Korea. To the contrary, human cysticercosis caused by T. solium has been reported frequently during the 1960's. The severity of human cysticercosis is a significant problem of public health in Korea. Old data on bovine cysticercosis in the 1920's and 1930's are not useful for present control measures. Systematic surveys on bovine and swine cysticercosis as well as taeniasis and human cysticercosis are needed in Korea. Cases of sparganosis have been reported frequently during the past 15 years. Most of the 34 cases of sparganosis reported involved the eating of raw snakes and frogs. Most of the cases occurred in older males. Sparganosis in snakes, frogs, chickens, and swine has been reported in Korea. Human infection of Hymenolepis nana ranged from 0.2% to 1.4% discovered by stool examination. A few cases of adult worm collections of Diphyllobothrium latum and Hymenolepis diminuta have been reported in Korea. Two cases of human hydatid disease have been reported in Korea. No study on the disease in domestic animals is available. No case of human infection with dog tapeworm has been reported, even though it is highly prevalent in the indigenous dogs in Korea. I recommend that further study on the zoonotic tapeworms be conducted epidemiologically in Korea to get basic data for the public health programming. PMID:977229

Moon, J R

1976-06-01

237

Cutaneous Larva Migrans.  

PubMed

International travel and increasingly exotic diets have resulted in an increase in cases of cutaneous larva migrans in industrialized countries. A broader spectrum of clinical presentation and complications of cutaneous larva migrans is recognized by clinicians. A new syndrome, eosinophilic enteritis, has been described in Australia and may be more widespread as new diagnostic tests are used more widely. Other causes of cutaneous migration, such as gnathostomiasis and sparganosis, should be considered, and a recent outbreak of gnathostomiasis in Mexico suggests that clinicians must be alert to these unusual infections arising in patients outside their traditional distribution. PMID:14733849

Gillespie, Stephen H.

2004-02-01

238

Neuroparasitic Infections: Cestodes, Trematodes, and Protozoans  

PubMed Central

Parasitic infection of the nervous system can produce a variety of symptoms and signs. Because symptoms of infection are often mild or nonspecific, diagnosis can be difficult. Familiarity with basic epidemiological characteristics and distinguishing radiographic findings can increase the likelihood of detection and proper treatment of parasitic infection of the nervous system. This article discusses the clinical presentation, diagnosis, and treatment for some of the more common infections of the nervous system caused by cestodes, trematodes and protozoans: Echinococcus spp., Spirometra spp. (sparganosis), Paragonimus spp., Schistosoma spp., Trypanosoma spp., Naegleria fowlerii, Acanthamoeba histolytica, and Balamuthia mandrillaris.

Walker, M.D.; Zunt, J.R.

2009-01-01

239

Parasitic diseases of the central nervous system.  

PubMed

This article reviews the characteristic imaging appearances of parasitic diseases of the central nervous system, including cysticercosis, toxoplasmosis, cystic echinococcosis, schistosomiasis, amebiasis, malariasis, sparganosis, paragonimiasis, and American and African trypanosomiases. Routine precontrast and postcontrast MR imaging helps in localization, characterization, delineation of extension, and follow-up of the parasitic lesions. Moreover, recently developed tools, such as diffusion, perfusion, and MR spectroscopy, help to differentiate parasitic diseases of the central nervous system from simulating lesions. Combining imaging findings with geographic prevalence, clinical history, and serologic tests is required for diagnosis of parasitic diseases of the central nervous system. PMID:22032501

Abdel Razek, Ahmed Abdel Khalek; Watcharakorn, Arvemas; Castillo, Mauricio

2011-11-01

240

Tracheal stenosis mimicking severe acute asthma  

Microsoft Academic Search

Post-intubation tracheal stenosis is a rare but serious clinical entity that rarely develops when intubation is less than a week. These patients may remain asymptomatic for a variable period and are often misdiagnosed as asthmatic. The authors report a case of a middle-aged lady who was initially misdiagnosed as having acute asthma after brief tracheal intubation.

Ali Bin Sarwar Zubairi; Babar Dildar; Shahid Javed Husain; Mohammad Faisal Khan

2010-01-01

241

Pentastomiasis and other parasitic zoonoses from reptiles and amphibians.  

PubMed

Reptiles are growing in popularity as pets.The colonization of reptiles and amphibians by parasites and the resulting disease conditions are the most common problems seen in captive animals.This review focuses on pentastomiasis and sparganosis, important parasitic zoonoses of reptiles and amphibians, respectively, and free living-amoebae. Humans are suitable accidental hosts for some pentastomid species (particularly Armillifer and Porocephalus). In geographical areas with special ethnics, such as in West and Central Africa, and East Asia, 8-45% of the human population can be affected. Usually the larvae are coincidentally found during abdominal surgeries. However, fatalities have been described. Extreme caution is necessary when handling infected reptiles. Ocular or cerebral sparganosis is not uncommonly found in humans in East Asia. This disease is caused by spargana, tapeworm larvae (plerocercoids) of Spirometra sp. The infection occurs when uncooked meat from reptiles or amphibians is applied to wounds or eyes and the parasites migrate directly to human tissue, or by consumption of contaminated food or water. As a consequence of the reptile's predatory behaviour, the full spectrum of endo- and ectoparasites from potential prey animals can be found as transiting parasites in the intestinal tract, e. g. Hymenolepis nana, Cryptosporidium (C.) muris, C parvum or Capillaria hepatica. Occasionally, free-living amoebae are also found in reptile faeces (Acanthamoeba, Naegleria, Hartmanella, Vahlkampfia or Echinamoeba sp.). PMID:22191176

Pantchev, Nikola; Tappe, Dennis

2011-01-01

242

Epidemiological significance of sero-positive inhabitants against sparganum in Kangwon-do, Korea.  

PubMed

Sparganum is a plerocercoid of pseudophyllidean tapeworms, Diphyllobothrium or Spirometra spp. Human sparganosis is endemic mainly in East and Southeast Asian countries where the custom of eating raw snake or frog meat, or poulticing with snake's skin exists. From January 1995 to November 1999, an epidemiological survey was undertaken to evaluate the serum levels of anti-sparganum specific IgG antibodies in Whachon-gun residents, Korea. An enzyme- linked immunosorbent assay (ELISA) and immunoblot analysis of the sera from 316 subjects were used. In addition, a stool examination from 416 inhabitants and questionnaires regarding the consumption of raw meat were given. Out of 416 inhabitants examined coprologically, one was infected with Clonorchis sinensis and two were infected with Metagonimus spp. The sera from 36 inhabitants (11.4 %) showed a positive reaction to the sparganum antigen. Out of these 36 inhabitants, the sera from 25 people were examined 7, 19, and 50 months later. The sera were found to still show positive reactions without any remarkable changes of anti-sparganum specific antibody titers except for one. An analysis of the questionnaires suggested that a history of eating of raw snakes or frogs was important risk factor for clinical or covert sparganosis (odd ratio=15.6 and 3.1, respectively). PMID:11519077

Park, H Y; Lee, S U; Kim, S H; Lee, P C; Huh, S; Yang, Y S; Kong, Y

2001-08-01

243

Spirometra (Pseudophyllidea, Diphyllobothriidae) Severely Infecting Wild-Caught Snakes from Food Markets in Guangzhou and Shenzhen, Guangdong, China: Implications for Public Health  

PubMed Central

Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January–August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0?96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans.

Gong, Shiping

2014-01-01

244

Spirometra (Pseudophyllidea, Diphyllobothriidae) severely infecting wild-caught snakes from food markets in Guangzhou and Shenzhen, Guangdong, China: implications for public health.  

PubMed

Sparganosis is a zoonotic disease caused by the spargana of Spirometra, and snake is one of the important intermediate hosts of spargana. In some areas of China, snake is regarded as popular delicious food, and such a food habit potentially increases the prevalence of human sparganosis. To understand the prevalence of Spirometra in snakes in food markets, we conducted a study in two representative cities (Guangzhou and Shenzhen), during January-August 2013. A total of 456 snakes of 13 species were examined and 251 individuals of 10 species were infected by Spirometra, accounting for 55.0% of the total samples. The worm burden per infected snake ranged from 1 to 213, and the prevalence in the 13 species was 0?96.2%. More than half (58.1%) of the spargana were located in muscular tissue, 25.6% in subcutaneous tissue, and 16.3% in coelomic cavity. The results indicated that Spirometra severely infected snakes in food markets in Guangzhou and Shenzhen, implying that eating snakes has great health risk and improper cooking methods may increase the risk of Spirometra infection in humans in China. Additional steps should be considered by the governments and public health agencies to prevent the risk of snake-associated Spirometra infections in humans. PMID:24558340

Wang, Fumin; Li, Weiye; Hua, Liushuai; Gong, Shiping; Xiao, Jiajie; Hou, Fanghui; Ge, Yan; Yang, Guangda

2014-01-01

245

75 FR 28621 - Proposed Data Collections Submitted for Public Comment and Recommendations  

Federal Register 2010, 2011, 2012, 2013

...gender, and family history) associated with the disease; and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

2010-05-21

246

75 FR 69086 - Agency Forms Undergoing Paperwork Reduction Act Review  

Federal Register 2010, 2011, 2012, 2013

...family history of individuals diagnosed with the disease); and (4) better examine the connection between ALS and other motor neuron disorders that can be confused with ALS, misdiagnosed as ALS, and in some cases progress to ALS. The registry will...

2010-11-10

247

Quit Obsessing!  

ERIC Educational Resources Information Center

Asserts the obsessive-compulsive disorder is often misdiagnosed in children and adolescents; describes characteristics of obsessive-compulsive disorder; differentiates between normal and abnormal obsessions; suggests ways teachers can help students diagnosed with the disorder. (PKP)

Schlozman, Steven C.

2002-01-01

248

How Fetal Alcohol Spectrum Disorders Co-Occur with Mental Illness  

MedlinePLUS

... and symptoms of FASD are similar to various mental health disorders. In many cases, the signs and symptoms of an FASD go unrecognized or are misdiagnosed as a mental illness or brain injury. Individuals with an FASD ...

249

Pseudogout  

MedlinePLUS

... that can cause attacks of arthritis . Like with gout, crystals form in the joints. But in pseudogout, ... similar, pseudogout can be misdiagnosed as: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis

250

Recognition and Initial Assessment of Alzheimer's Disease and Related Dementias. Clinical Practice Guideline Number 19; Early Identification of Alzheimer's Disease and Related Dementias. Quick Reference Guide for Clinicians Number 19; Early Alzheimer's Disease, Consumer Version. Patient and Family Guide.  

National Technical Information Service (NTIS)

Dementia in the adult U.S. Population is a devastating disorder that is often unrecognized or misdiagnosed in its early stages. Despite the current lack of unequivocally effective treatment, recognition of early-state dementia may offer substantial benefi...

A. Heyman A. W. Kaszniak B. J. Gurland L. P. Gwyther M. F. Folstein M. S. Albert N. M. Butters P. T. Costa S. Gilman T. F. Williams

1996-01-01

251

Frontotemporal Disorders (Frontotemporal Lobar Degeneration)  

MedlinePLUS

... recognized as clinical entities separate from Alzheimer’s disease (AD). Until recently, many of these conditions were routinely misdiagnosed as AD or a psychiatric disorder, and very little was ...

252

Squamous cell carcinoma arising from a localized vulval lesion of Hailey-Hailey disease after tacrolimus therapy.  

PubMed

Hailey-Hailey disease (HHD) is a rare, autosomal dominant intraepidermal blistering disorder characterized by recurrent vesicles and erosions affecting mostly the intertriginous areas. We report a case of HHD affecting exclusively the vulva from which an invasive squamous cell carcinoma developed after tacrolimus therapy. PMID:20816142

von Felbert, Verena; Hampl, Monika; Talhari, Carolina; Engers, Rainer; Megahed, Mosaad

2010-09-01

253

Fournier’s Gangrene: A Monographic Urology Center Experience with Twenty Patients  

Microsoft Academic Search

Background: Fournier’s gangrene (FG) is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in males and the vulva in females. The aim of this study was to share our experience in the management of this infectious disease. Methods: A retrospective chart review was performed in 20 patients with

R. Martínez-Rodríguez; J. Ponce de León; J. Caparrós; H. Villavicencio

2009-01-01

254

Visual depictions of female genitalia differ depending on source  

Microsoft Academic Search

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. The objective of the present work was to determine if visual depictions of the vulva differed according

Helena Howarth; Volker Sommer; Fiona M Jordan

2010-01-01

255

Urogenital tumors  

SciTech Connect

An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

Weller, R.E.

1994-03-01

256

Protocylindrocorpus dendrophilus n. sp. (Nematoda: Cylindrocorpidae) Associated with Pine Wood Borings  

PubMed Central

Protocylindrocorpus dendrophilus n. sp. is described from xylem samples taken from beetle infested slash pine (Pinus elliottii Engelmann var. elliottii) in Central Louisiana. It is similar to P. goodeyi (Rühm) Paramonov, but differs by the possession of a protuberant and more posteriorly located vulva and in the position of the caudal papillae. Morphometrics of the male and female are presented.

Kinn, D. N.

1984-01-01

257

Protocylindrocorpus dendrophilus n. sp. (Nematoda: Cylindrocorpidae) Associated with Pine Wood Borings.  

PubMed

Protocylindrocorpus dendrophilus n. sp. is described from xylem samples taken from beetle infested slash pine (Pinus elliottii Engelmann var. elliottii) in Central Louisiana. It is similar to P. goodeyi (Rühm) Paramonov, but differs by the possession of a protuberant and more posteriorly located vulva and in the position of the caudal papillae. Morphometrics of the male and female are presented. PMID:19295889

Kinn, D N

1984-04-01

258

Anatomical study on true hermaphroditism in an Indian pig (Sus Scrofa Domesticus)  

Microsoft Academic Search

A pig was confirmed to be a true hermaphrodite on the basis of gross and histomorphological studies of the genital organs. The genitalia was consisted of left ovary, oviduct, two coiled uterine horns, body of uterus alongwith right testis and an epididymis. Vagina and vulva were absent but male urethra with prostate gland was present. Grossly the size of all

Neelam Bansal; K. S. Roy; D. K. Sharma; Rajnish Sharma

259

A polycystic kidney-disease gene homologue required for male mating behaviour in C. elegans  

Microsoft Academic Search

The stereotyped mating behaviour of the Caenorhabditis elegans male is made up of several substeps: response, backing, turning, vulva location, spicule insertion and sperm transfer. The complexity of this behaviour is reflected in the sexually dimorphic anatomy and nervous system. Behavioural functions have been assigned to most of the male-specific sensory neurons by means of cell ablations; for example, the

Maureen M. Barr; Paul W. Sternberg

1999-01-01

260

Successful Treatment with Lymphaticovenular Anastomosis for Secondary Skin Lesions of Chronic Lymphedema  

Microsoft Academic Search

The treatment of severe lymphedema is a difficult challenge. We performed lymphaticovenular anastomosis on two patients with secondary skin lesions of chronic lymphedema; one patient exhibited acquired lymphangioma circumscriptum of the vulva and the other presented elephantiasis nostras verrucosa of the lower leg. Both patients obtained a remarkable improvement in skin lesions and also in the reduction of lymphedema of

Sei-ichiro Motegi; Atsushi Tamura; Etsuko Okada; Yayoi Nagai; Osamu Ishikawa

2007-01-01

261

Genetic Control of Vulval Development in Caenorhabditis briggsae  

PubMed Central

The nematode Caenorhabditis briggsae is an excellent model organism for the comparative analysis of gene function and developmental mechanisms. To study the evolutionary conservation and divergence of genetic pathways mediating vulva formation, we screened for mutations in C. briggsae that cause the egg-laying defective (Egl) phenotype. Here, we report the characterization of 13 genes, including three that are orthologs of Caenorhabditis elegans unc-84 (SUN domain), lin-39 (Dfd/Scr-related homeobox), and lin-11 (LIM homeobox). Based on the morphology and cell fate changes, the mutants were placed into four different categories. Class 1 animals have normal-looking vulva and vulva-uterine connections, indicating defects in other components of the egg-laying system. Class 2 animals frequently lack some or all of the vulval precursor cells (VPCs) due to defects in the migration of P-cell nuclei into the ventral hypodermal region. Class 3 animals show inappropriate fusion of VPCs to the hypodermal syncytium, leading to a reduced number of vulval progeny. Finally, class 4 animals exhibit abnormal vulval invagination and morphology. Interestingly, we did not find mutations that affect VPC induction and fates. Our work is the first study involving the characterization of genes in C. briggsae vulva formation, and it offers a basis for future investigations of these genes in C. elegans.

Sharanya, Devika; Thillainathan, Bavithra; Marri, Sujatha; Bojanala, Nagagireesh; Taylor, Jon; Flibotte, Stephane; Moerman, Donald G.; Waterston, Robert H.; Gupta, Bhagwati P.

2012-01-01

262

Vulvar lichen sclerosus: clinical aspects and guidelines to management  

Microsoft Academic Search

Lichen sclerosus is the second most frequently en- countered non-neoplastic disorder of the vulva. For this rea- son, gynecologists, dermatologists and primary care physicians should have a good understanding of the disease and its treat- ment. Most patients present with significant pruritus and, on examination, will be found to have white patches or plaques extending from the vestibule to the

PETER J. LYNCH; LEONARDO MICHELETTI; FABRIZIO BOGLIATTO

263

Oocyte signals derived from polyunsaturated fatty acids control sperm recruitment in vivo  

Microsoft Academic Search

A fundamental question in animal development is how motile cells find their correct target destinations. During mating in the nematode Caenorhabditis elegans, males inject sperm through the hermaphrodite vulva into the uterus. Amoeboid sperm crawl around fertilized eggs to the spermatheca – a convoluted tube where fertilization occurs. Here, we show that polyunsaturated fatty acids (PUFAs), the precursors of eicosanoid

Homare M. Kubagawa; Jennifer L. Watts; Chad Corrigan; Johnathan W. Edmonds; Elizabeth Sztul; John Browse; Michael A. Miller

2006-01-01

264

Differential expression of the 27 kDa cathepsin L-like cysteine protease in developmental stages of Spirometra erinacei  

PubMed Central

The 27 kDa cathepsin L-like cysteine protease of Spirometra erinacei plerocercoid is known to play an important function in tissue penetration, nutrient uptake and immune modulation in human sparganosis. In the present study, the expression of this enzyme was examined at different developmental stages of S. erinacei including immature egg, coracidium, plerocercoid in tadpole and rat, and adult. Proteolytic activity against carboxybenzoyl-phenylalanyl-arginyl-7-amino-4-methylcoumarin was detected in the extracts of coracidia and plerocercoid while no activity was observed in those of immature egg and adult. The specific activity in coracidial extracts was lower than that in the plerocercoid. Reverse transcription-polymerase chain reaction and Northern blot analysis demonstrated that the gene was expressed in the coracidium and plerocercoid but not in immature egg and adult. These results suggest that the 27 kDa cysteine protease is only expressed in the stages involving active migration of the parasite in the host tissue.

Kong, Yoon; Yun, Doo-Hee; Cho, Seung-Yull; Sohn, Woon-Mok; Chung, Young-Bae

2000-01-01

265

[Intestinal Perforation Due To Infection Of Sparganum Mansoni  

PubMed

In May 1974, authors encountered a 37 year old Korean male who was suffering from very serious condition of acute abdomen. On exploratory laparotomy, a ruptured granulomatous mass in the proximal portion of the ileum showing extensive inflammatory and gangrenous changes was found and about 4 ft. long of the bowel was resected. From the honey-combed fibrous capsules in the mass, four plerocercoid larvae, spargana, measuring about 3 to 7 cm in lengths were extirpated. The patient had a past history of having eaten the raw flesh of a snake as a tonic about 7 months prior to admission. Four cases of intra-abdominal sparganosis reported previously in Korea and the present case were discussed briefly. Snakes and frogs in Korea are very important second intermediate hosts for the 1arva, Sparganum stage. It is most preferable that the habitual ingestion of the raw fleshes of them should be avoided in this country. PMID:12913452

Min, Hong Ki; Han, Sang Ho; Yoon, Sei Ok; Oh, Chang Hyun

1976-06-01

266

Immunodiagnosis of alveolar echinococcosis by enzyme-linked immunosorbent assay using a partially purified Em18/16 enriched fraction.  

PubMed Central

An improved enzyme-linked immunosorbent assay (ELISA) system using partially purified Eml8/16 enriched fraction (PP-Em18/16) prepared by isoelectric focusing was evaluated for serodiagnosis of alveolar echinococcosis (AE). The PP-Em18/16-ELISA was compared with Em2plus-ELISA by using sera from AE and cystic echinococcosis (CE) patients in China, where both AE and CE are endemic; sera from CE patients in Australia, where only CE exists; and sera from patients with cysticercosis, paragonimiasis, or sparganosis in Korea, where no indigenous AE or CE exists. We used Em2plus-ELISA as a standard ELISA and found 24.6% (17 of 69 specimens) cross-reactivity with sera from CE. Furthermore, some of the sera from paragonimiasis, sparganosis, and cysticercosis patients were also cross-reactive in the Em2plus-ELISA. When we tested for similar cross-reactivity in the same sera from CE patients by PP-Em18/16-ELISA (23.2%, 16 of 69), it became evident that the specificity of the PP-Em18/16-ELISA was better than that of the Em2plus-ELISA, since no sera from patients with the examined parasitic diseases except CE showed cross-reactivity. Some CE patients from China showed exceptionally high levels of antibody in comparison with those of CE patients from Australia, where no AE occurs. It is speculated that these patients with strongly positive cases of CE from China may have been exposed to both species of Echinococcus.

Ito, A; Ma, L; Itoh, M; Cho, S Y; Kong, Y; Kang, S Y; Horii, T; Pang, X L; Okamoto, M; Yamashita, T; Lightowlers, M W; Wang, X G; Liu, Y H

1997-01-01

267

Magnetic resonance imaging of vulvar dermatofibrosarcoma protuberans - report of a case  

PubMed Central

Background Dermatofibrosarcoma protuberans (DFSP) of the vulva is a rare low-grade soft tissue sarcoma. Magnetic resonance imaging (MRI) findings of vulvar DFSP were essentially unreported in the literature. Case report We report a DFSP of vulva with its clinical, histological and MRI features. As far we know this is the first case of histologically confirmed vulvar DFSP presenting with MR images. The diagnosis of DFSP is usually made by histopathologic and clinical findings. Conclusions MRI is useful both for the diagnosis of DFSP and following up the patients since it has high soft tissue resolution and no risk of radiation exposure. With MRI the relation to the adjacent anatomical structures, extension and depth of the tumour and possible lymph node involvement can also be demonstrated.

Ozmen, Evrim; Guney, Guven; Algin, Oktay

2013-01-01

268

A new species of Protrellus Cobb, 1920 (Nematoda, Thelastomatidae) parasite of the field cockroach Blatella vaga Hebard, 1919 (Blattodea, Blattidae) from Catamarca, Argentina.  

PubMed

A new species of the genus Protrellus, P. blatta sp. nov. parasitizing a field cockroach Blatella vaga Hebard, 1919, from El Tala river, Catamarca, Argentina, is described and illustrated. It is characterized by having the mouth opening circular, the buccal capsule with eight very small teeth, the nerve ring around oesophageal corpus, the excretory pore anterior to vulva, the vulva anterior to base of oesophagus, didelphic, the posterior ovary reflexed anterior to rectum, about one third of a body length from posterior end, the egg ellipsoidal, colourless, bearing a lateral cuticular crest, tail conical, with long filiform projection, the male with testis single, outstretched, one spicule, very small, short and straight, gubernaculums absent, the genital papillae arranged in three pairs of ventrolateral papillae, of which the first pair are close together and preanal position, two pairs postanal, tail conical and short, less than one twentieth of total body. A taxonomic key of Protrellus species is given. PMID:23377918

Camino, Nora B; de Villalobos, Cristina

2013-03-01

269

Phototoxic effect of Thamnosma texana (Dutchman's breeches) in sheep.  

PubMed

Oral exposure of sheep to the airdried, aerial portions of Thamnosma texana (Dutchman's breeches) resulted in severe photosensitization. Sheep fed the plant at 9 or 12 g/kg of body weight/day and held in direct sunlight exhibited signs of phototoxicosis within 24 to 48 hours. The clinical signs manifested were increased body temperature; photophobia; edema of the muzzle, ears, and vulva; keratoconjunctivitis with edema of the cornea; and exudative dermatitis of the skin of the ears, muzzle, and vulva. Lesser dosages of the plant produced similar effects after several days, except that corneal edema and opacity were not seen. Histopathologic studies indicated no hepatic lesions, consistent with primary photosensitization. The photosensitizing effects of T texana can be attributed to the presence of photosensitizing linear furocoumarins (psoralens) in the plant. PMID:6870019

Oertli, E H; Rowe, L D; Lovering, S L; Ivie, G W; Bailey, E M

1983-06-01

270

An approach to the treatment of anogenital pruritus.  

PubMed

The anogenital area is a common location for pruritic complaints. Specific terms for chronic itch in this location have included pruritus vulvae, pruritus ani, lichen simplex chronicus, and neurodermatitis. A male counterpart to pruritus vulvae, pruritus scroti, is less common. Acute anogenital pruritus is usually caused by infections or contact dermatitis. In chronic pruritus, inflammatory dermatoses and malignancies must be ruled out. In idiopathic anogenital pruritus or neurodermatitis, the skin findings should be limited to lichenification and excoriations. Skin findings may be entirely absent. When treating anogenital pruritus, topic irritants and potential sensitizers must be eliminated. Cleansing and toilet habits must be addressed. A short course of a high-potency topical steroid should bring moderate to complete relief. Sedating antihistamines may limit nighttime symptoms. In some patients, psychotropic agents are required to achieve adequate sedation. Antidepressants may be required in patients refractory to treatment or with underlying psychiatric disorders. PMID:14756897

Weichert, Gabriele E

2004-01-01

271

Revision of the family Acidopsidae Štev?i?, 2005, and the systematic position of Typhlocarcinodes Alcock, 1900, Caecopilumnus Borradaile, 1902, and Raoulia Ng, 1987, with descriptions of two new genera and five new species (Crustacea: Brachyura: Goneplacoidea).  

PubMed

The family Acidopsidae Štev?i?, 2005, is revised; and two subfamilies are recognised. The Acidopsinae Štev?i?, 2005, is characterised by the coxal male opening, a quadrate basal antennal article and vulvae arranged near the median longitudinal thoracic sternal groove. Three genera are included in the Acidopsinae: Acidops Stimpson, 1871 (with two species), Parapilumnus Kossmann, 1877 (with two species) and Crinitocinus gen. nov. (monotypic for Pilumnus alcocki Borradaile, 1902). The Raouliinae Štev?i?, 2005 (= Typhlocarcinodidae Štev?i?, 2005; Caecopilumnidae Štev?i?, 2011), is characterised by its coxo-sternal male opening, a short basal antennal article which is distinctly wider than long and vulvae arranged submedially on thoracic sternite 6. Four genera are included in the Raouliinae: Raoulia Ng, 1987 (with five species, three of which are described as new), Caecopilumnus Borradaile, 1902 (with three species of which one is described as new), Typhlocarcinodes Alcock, 1900 (monotypic) and Thecaplax gen. nov. (for one new species).  PMID:24871283

Ng, Peter K L; Rahayu, Dwi Listyo

2014-01-01

272

Bilateral fibroepithelial polypi of labium minus with atypical stromal cells.  

PubMed

A case of fibroepithelial polyp of labium minus with stromal atypia is described. This unusual tumor has only recently been reported occurring in the vulva. The tumor measured 12 cm in maximal diameter and its cut surface was soft and myxoid. After fixation the tumor was considerably smaller in size. The light microscopic findings were of a loose acellular myxoid stroma, traversed by thin walled dilated vascular spaces and covered by stratified squamous epithelium and with sparse fibroblast-like cells dispersed throughout. This case is unusual as fibroepithelial polyps with stromal atypia are an uncommon tumor of the vulva, are rarely bilateral and in this site no lesion previously has exceeded 4.0 cm in diameter. PMID:1579366

Carter, J; Elliott, P; Russell, P

1992-01-01

273

Female Genital Surgery  

Microsoft Academic Search

\\u000a Our society attributes great importance to appearance and body image. In the recent past, cosmetic vulvar plastic surgery\\u000a has been widely introduced in the western world. Modification of the cultural environment and increasing vulvar “visibility”\\u000a have generated the erroneous identification of an ideally “normal” appearing vulva. The links between partner’s relationship,\\u000a sexuality, and body image have become more strict, and

Francesca De Lorenzi; Elena Mascolo; Francesca Albani; Mario Sideri

274

Patients with usual vulvar intraepithelial neoplasia-related vulvar cancer have an increased risk of cervical abnormalities  

Microsoft Academic Search

Background:Vulvar squamous cell carcinoma (SCC) originates the following two pathways, related to differentiated (d) vulvar intraepithelial neoplasia (VIN) or to human papillomavirus (HPV)-related usual (u) VIN. Multicentric HPV infections (cervix, vagina and vulva) are common. We hypothesise that patients with a uVIN-related vulvar SCC more often have cervical high-grade squamous intraepithelial lesions (HSILs) compared with women with dVIN-related vulvar SCC.Methods:All

R. P. de Bie; H. P. van de Nieuwenhof; R. L. M. Bekkers; W. J. G. Melchers; A. G. Siebers; J. Bulten; L. F. A. G. Massuger; J. A. de Hullu; RP de Bie

2009-01-01

275

The small ubiquitin-like modifier (SUMO) is required for gonadal and uterine-vulval morphogenesis in Caenorhabditis elegans  

Microsoft Academic Search

The small ubiquitin-like modifier (SUMO) modification alters the subcellular distribution and function of its substrates. Here we show the major role of SUMO during the development of the Caenorhabditis elegans reproductive system. smo-1 deletion mutants develop into sterile adults with abnormal somatic gonad, germ line, and vulva. SMO-1GFP reporter is highly expressed in the somatic reproductive system. smo-1 animals lack

Limor Broday; Irina Kolotuev; Christine Didier; Anindita Bhoumik; Bhagwati P. Gupta; Paul W. Sternberg; Benjamin Podbilewicz; Ze' ev Ronai

2004-01-01

276

[Bartholin's gland carcinoma].  

PubMed

Bartholin gland carcinoma is a rare tumor. Treatment is not consensual due to the absence of prospective and randomized controlled trials. Bartholin gland carcinoma is actually treated similarly to primary median squamous cell carcinoma of the vulva. Here we report two cases of 42- and 67-year-old females who developed respectively an adenoid cystic carcinoma, and a squamous carcinoma of Bartholin gland. PMID:24951185

Chraibi, Z; Hebert, T; Body, G; Arbion, F; Ouldamer, L

2014-01-01

277

The KLP-6 Kinesin Is Required for Male Mating Behaviors and Polycystin Localization in Caenorhabditis elegans  

Microsoft Academic Search

Background: Male mating behavior of the nematode Caenorhabditis elegans offers an intriguing model to study the genetics of sensory behavior, cilia function, and autosomal dominant polycystic kidney disease (ADPKD). The C. elegans polycystins LOV-1 and PKD-2 act in male-specific sensory cilia required for response and vulva-location mating behaviors.Results: Here, we identify and characterize a new mating mutant, sy511. sy511 behavioral

Erik M. Peden; Maureen M. Barr

2005-01-01

278

Differential responses of EGFR\\/AGT-expressing cells to the \\  

Microsoft Academic Search

Purpose. Previous studies have demonstrated enhanced potency associated with the binary [DNA\\/epidermal growth factor receptor (EGFR)] targeting properties of SMA41 (a chimeric 3-(alkyl)-1,2,3-triazene linked to a 4-anilinoquinazoline backbone) in the A431 (epidermal carcinoma of the vulva) cell line. We now report on the dependence of its antiproliferative effects (e.g. DNA damage, cell survival) on the EGFR and the DNA repair

Stephanie L. Matheson; James P. McNamee; Bertrand J. Jean-Claude

2003-01-01

279

Femoral neck fracture following groin irradiation  

Microsoft Academic Search

Purpose: The incidence and risk factors are evaluated for femoral rneck fracture following groin irradiation for gynecologic malignancies.Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group,

Perry W. Grigsby; Heidi L. Roberts; Carlos A. Perez

1995-01-01

280

Management of Extramammary Paget's Disease: A Case Report and Review of the Literature  

PubMed Central

Extramammary Paget's Disease (EMPD) is a rare condition of the skin that often involves the vulva, perianal region, scrotum, penis, and axilla. Although prognosis is generally favorable, it can be associated with neoplasms of the bladder, urethra, prostate, and rectum. This report presents a case of scrotal EMPD that failed treatment with imiquimod 5% cream and discusses benefits and complications of available treatment options. The variation of treatment success emphasizes the importance of further research.

2013-01-01

281

Partial bladder resection in a bitch with urinary retention following surgical excision of a vaginal leiomyoma.  

PubMed

Ovariohysterectomy and surgical excision of a vaginal leiomyoma were performed in a bitch exhibiting continuous bleeding from the vulva. Following excision of the tumour, urine retention and urinary incontinence developed. Treatment using drugs and an indwelling catheter was unsuccessful in correcting the disorders and chronic cystitis developed after long-standing urine stagnation in the bladder. The authors resorted to undertaking partial cystectomy in order to correct the condition, which resulted in reduced urine retention and improved micturition. PMID:11440400

Tanaka, R; Hoshi, K; Yamane, Y

2001-06-01

282

A v-erbB-Related Protooncogene, c-erbB-2, is Distinct from the c-erbB-1\\/Epidermal Growth Factor-Receptor Gene and is Amplified in a Human Salivary Gland Adenocarcinoma  

Microsoft Academic Search

From a human genomic library, we obtained six v-erbB-related DNA clones. A DNA probe prepared from one of the clones, lambda 107, hybridized to EcoRI fragments of 6.4 and 13 kilobase pairs of human DNA. Neither of these fragments was amplified in A431 vulva carcinoma cells, in which the gene encoding the epidermal growth factor receptor is amplified. In addition,

Kentaro Semba; Nobuyuki Kamata; Kumao Toyoshima; Tadashi Yamamoto

1985-01-01

283

Vaginal cavernous hemangioma with cystic ovaries and cystic endometrial hyperplasia in a dog  

Microsoft Academic Search

A 10-year-old intact female German shepherd dog was presented with a chief compliant of vaginal bleeding that had become progressively\\u000a heavier over a 2-week period. On clinical examination, the abdominal cavity was distended, and no wounds or masses were observed\\u000a in vulva and caudal vaginal regions. Digital vaginal examination and vaginoscopy had no specific findings. Abdominal ultrasonography\\u000a and radiography revealed

Omid Azari; Baharak Akhtardanesh; Amin Derakhshanfar; Mohammad Mehdi Oloumi; Daruosh Vosough

2010-01-01

284

Guidelines for the follow-up of women with vulvar lichen sclerosus in specialist clinics.  

PubMed

It is recommended that women with vulvar lichen sclerosus be followed in specialist clinics where difficulty exists with symptom control or where there is clinical evidence of localized skin thickening. Follow-up is also recommended for women who have previously been treated for squamous cell carcinoma of the vulva (arising in lichen sclerosus or vulvar intraepithelial neoplasia) or where the pathologist expresses concern and is unable to make a definitive diagnosis of differentiated vulvar intraepithelial neoplasia. PMID:17905173

Jones, Ronald W; Scurry, James; Neill, Sallie; MacLean, Allan B

2008-05-01

285

Perioral dermatitis -- the role of nasal steroids.  

PubMed

We present two patients with allergic rhinitis who developed perioral dermatitis (PD) after initiating intranasal steroid spray. Both patients had been previously misdiagnosed as having contact or seborrheic dermatitis, and therefore inappropriately and unsuccessfully treated with topical steroids. Physicians should be aware of this potential side effect of intranasal steroids to avoid incorrect therapeutic measures. In the setting of nasal steroids use, PD probably is an under-reported and commonly misdiagnosed condition that should be thought when a patient treated with nasal steroids present with small erythematous papules, papulovesicles, and papulopustules occurring against a background of redness, beginning in the nasolabial areas and spreading rapidly to the perioral zone. PMID:21995785

Peralta, Lígia; Morais, Paulo

2012-06-01

286

Granulocytic sarcoma of the breast in acute myeloid leukemia: Two case reports  

PubMed Central

Granulocytic sarcoma (GS) of the breast is extremely rare in patients with acute myeloid leukemia (AML) and therefore, is often misdiagnosed as lymphoma or other benign tumors. The current report presents two cases of GS of the breast, of which, one was considered to be a fibroma, as observed by fine-needle aspiration, and the other was misdiagnosed as lymphoma by frozen section. Previous literature that described the clinical and pathological characteristics, treatments and prognosis of GS of the breast in AML were reviewed. In addition to the treatment of mastectomy with/without radiotherapy, lumpectomy may also be received as a good treatment plan.

FU, JIANFEI; LUO, JIANSHENG

2014-01-01

287

Surgical correction of labial fusion with vaginoplasty in a cat.  

PubMed

A spayed female domestic shorthair cat was first examined at the age of 16 months because of persistent licking of the perineal area. The cat had a grossly enlarged and oedematous vulva with pronounced superficial pyoderma of the perivulvar area, which responded favourably to systemic antibiotics, analgesics and local corticosteroids. A month after the initial examination, the cat was re-presented owing to pollakiuria, stranguria and dyschesia. The oedema of the vulva had disappeared and the vulvar labia were fused together; there was only a fistulous tract with a diameter of 1 mm present in the area of the vulva, and the cat strained to urinate through that opening. A contrast study revealed normal transit through the lower urinary tract, but labial adhesions resulted in the development of dilation cranially, where the vaginal vestibule was supposed to be. Vaginoplasty was subsequently performed, the cat recovered normally and, 10 months after the procedure, the lumen of the vaginostoma is preserved and the cat is urinating without difficulty. PMID:23253882

Plavec, Tanja; Pavlin, Darja

2013-06-01

288

Repeated Vulvovaginal Fungal Infections Cause Persistent Pain in a Mouse Model of Vulvodynia  

PubMed Central

Provoked vestibulodynia, the most common form of vulvodynia (unexplained pain of the vulva), is a prevalent, idiopathic pain disorder associated with a history of recurrent candidiasis (yeast infections). It is characterized by vulvar allodynia (painful hypersensitivity to touch) and hyperinnervation. We tested whether repeated, localized exposure of the vulva to a common fungal pathogen can lead to the development of chronic pain. A subset of female mice subjected to recurrent Candida albicans infection developed mechanical allodynia localized to the vulva. The mice with allodynia also exhibited hyperinnervation with peptidergic nociceptor and sympathetic fibers (as indicated by increased protein gene product 9.5, calcitonin gene–related peptide, and vesicular monoamine transporter 2 immunoreactivity in the vaginal epithelium). Long-lasting behavioral allodynia in a subset of mice was also observed after a single, extended Candida infection, as well as after repeated vulvar (but not hind paw) inflammation induced with zymosan, a mixture of fungal antigens. The hypersensitivity and hyperinnervation were both present at least 3 weeks after the resolution of infection and inflammation. Our data show that infection can cause persistent pain long after its resolution and that recurrent yeast infection replicates important features of human provoked vulvodynia in the mouse.

Farmer, Melissa A.; Taylor, Anna M.; Bailey, Andrea L.; Tuttle, Alexander H.; MacIntyre, Leigh C.; Milagrosa, Zarah E.; Crissman, Halley P.; Bennett, Gary J.; Ribeiro-da-Silva, Alfredo; Binik, Yitzchak M.; Mogil, Jeffrey S.

2011-01-01

289

The vulvar epithelium differs from the skin: implications for cutaneous testing to address topical vulvar exposures.  

PubMed

Vulvar tissue is more permeable than exposed skin due to differences in structure, occlusion, hydration and susceptibility to friction. The safety assessment of products that contact the vulva should account for this potentially heightened permeability. Standard clinical patch tests may not sufficiently mimic vulvar exposures. Because testing on the vulva is not routinely feasible, we are investigating new and modified cutaneous test methods to increase the degree of conservatism of the safety assessment. To this end, we have 1) developed a method to assess chemical and frictional effects by means of repeated application to the popliteal fossa (the behind-the-knee test); 2) modified the quantitative risk assessment for the induction of allergic contact dermatitis; and 3) proposed a modified human repeat insult patch test for assessing materials intended for vulvar contact. Modification of the traditional 4-day, irritation patch test by using wet samples or compromized skin sites failed to enhance test sensitivity. Future studies will evaluate testing in subjects with heightened susceptibility to chemical and sensory irritation, in order to increase test sensitivity to chemical irritants. These approaches can be employed to augment the margin of safety when cutaneous test methods are applied to agents that contact the vulva. PMID:15500670

Farage, Miranda; Maibach, Howard I

2004-10-01

290

Mating clusters in the mosquito parasitic nematode, Strelkovimermis spiculatus.  

PubMed

Mating aggregations in the mosquito parasitic nematode, Strelkovimermis spiculatus, were investigated in the laboratory. Female postparasites, through their attraction of males and, remarkably, other females, drive the formation of mating clusters. Clusters may grow in size by merging with other individual or clusters. Female molting to the adult stage and reproductive success are enhanced in larger clusters. Male mating behavior is initiated when the female begins to molt to the adult stage by shedding dual juvenile cuticles posteriorly. Males coil their tail around the adult cuticle, migrating progressively along the female in intimate synchrony with the molting cuticle until the vulva is exposed and mating can occur. The first arriving male is assured of access to a virgin female, as his intermediate location between the vulva and subsequently arriving males blocks these competitors. Males deposit an adhesive gelatinous copulatory plug into and over the vulva before departing the female. Fecundity was greater in larger mating clusters, but this was a function of a greater rate of molting which is a prerequisite for mating. Males compete for virgin females by emerging and molting to the adult stage earlier than females. Mating aggregations have previously only been examined in snakes, but these studies have tended to be observational as snakes offer a challenging system for study. The relatively easy to culture and manipulate mermithid system may offer a model for experimental studies of male-male competition, protandry, copulatory plugs and female choice in mating clusters. PMID:24487076

Dong, Limin; Sanad, Manar; Wang, Yi; Xu, Yanli; Shamseldean, Muhammad S M; Gaugler, Randy

2014-03-01

291

Influence of menstruation on the microbiota of healthy women's labia minora as analyzed using a 16S rRNA gene-based clone library method.  

PubMed

The aim of this study was to determine the influence of menstruation on the bacterial population of healthy Japanese women's vulvas, especially the labia minora. Labia minora swabs were obtained from 10 premenopausal, nonpregnant Japanese women at premenstruation and on day 2 of menstruation. Vaginal swabs were also obtained from 3 out of the 10 women. No significant difference was found in the average bacterial cell count between the menstruation and premenstruation samples. Molecular analysis using a 16S rRNA gene-based clone library method detected 22 genera from the labia minora swabs (total 20), with the genus Lactobacillus being predominant at both premenstruation and during menstruation in 7 out of the 10 women. Of the other 3 women, 2 showed various kinds of bacterial species, including oral and fecal bacteria, with Atopobium vaginae and Gardnerella vaginalis predominating in the remaining woman's vulva in both conditions. In total, 6 out of 10 cases (60%) showed significantly different microbiota of the labia minora between the two conditions. These results imply that menstruation may promote a distortion of the bacterial flora around the vulva, although it causes no significant increase of the bacterial count. PMID:21266747

Shiraishi, Tsukasa; Fukuda, Kazumasa; Morotomi, Nobuo; Imamura, Yuri; Mishima, Junko; Imai, Shigeo; Miyazawa, Kiyoshi; Taniguchi, Hatsumi

2011-01-01

292

Determination of ovulation time in sows based on skin temperature and genital electrical resistance changes.  

PubMed

Different physical and physiological parameters may be used to determine ovulation time in sows. In the present study, we analysed the ear and vulvar skin temperature fluctuations, and the changes in genital electrical resistance, at a distance of 4, 8 and 12 cm from the vulva during oestrus in order to predict the time of ovulation. Multiparous sows were checked by transrectal real-time ultrasonography and luteinising hormone (LH) plasma concentration was determined. Temperature was measured using a thermoprecision infrared thermometer, and the electrical resistance was measured with a commercial resistance probe. All measurements were carried out every 12 hours from one day after the weaning to three days after oestrus onset. Skin temperature showed significant difference around periovulatory period. The electrical resistance at 4 cm from the vulva showed marked changes during oestrus, which were different from those described at 8 and 12 cm from the vulva. At 12 hours before ovulation time, skin temperature decreased significantly, and negative correlation (P<0.05) was found between vulvar skin temperature and vaginal resistance. There was no relationship between skin temperature, electrical resistance and LH plasma concentration. The measurement of several physiological traits may provide more accurate predictions of the moment of ovulation. PMID:23709092

Luño, V; Gil, L; Jerez, R A; Malo, C; González, N; Grandía, J; de Blas, I

2013-06-01

293

Misdiagnosis of aneurysms: a case report.  

PubMed

Three cases in which aneurysms were misdiagnosed to less serous lesions are described. Attention is drawn to the possibility of these errors whose consequences can be fatal. Some of the problems associated with the handling of an inadvertently opened aneurysm are discussed. PMID:2285935

Sinzobahamvya, N; Chinyanga, H M; Clarke, N J; Dakovic, S; Harid, A C; Matenga, J

1990-09-01

294

Chylothorax after Primary Repair of Esophageal Atresia with Tracheo-esophageal Fistula: Successful Management by Biological Fibrin Glue.  

PubMed

A neonate, who had undergone primary repair of esophageal atresia with tracheo-esophageal fistula, developed right pleural effusion in the postoperative period. It was initially misdiagnosed as an anastomotic leak, but later confirmed to be chylothorax. Conservative treatment failed. Application of biological fibrin glue (sealant) on the mediastinum through a thoracotomy was curative. PMID:23061032

Dhua, Anjan Kumar; Ratan, Simmi K; Aggarwal, Satish K

2012-09-01

295

Chylothorax after Primary Repair of Esophageal Atresia with Tracheo-esophageal Fistula: Successful Management by Biological Fibrin Glue  

PubMed Central

A neonate, who had undergone primary repair of esophageal atresia with tracheo-esophageal fistula, developed right pleural effusion in the postoperative period. It was initially misdiagnosed as an anastomotic leak, but later confirmed to be chylothorax. Conservative treatment failed. Application of biological fibrin glue (sealant) on the mediastinum through a thoracotomy was curative.

Dhua, Anjan kumar; Ratan, Simmi K

2012-01-01

296

Spinal Canal Block Caused by Central Disc Protrusion.  

National Technical Information Service (NTIS)

Central disc protrusions are often misdiagnosed as other lesions, particularly those with block of spinal canal. Between October 1970 and February 1978 the author had 15 cases of spinal canal block due to central disc protrusions. Of these, 5 cases were i...

Z. Rongxun

1980-01-01

297

Serological Patterns of Brucellosis, Leptospirosis and Q Fever in Bos indicus Cattle in Cameroon  

Microsoft Academic Search

Brucellosis, leptospirosis and Q fever are important infections of livestock causing a range of clinical conditions including abortions and reduced fertility. In addition, they are all important zoonotic infections infecting those who work with livestock and those who consume livestock related products such as milk, producing non-specific symptoms including fever, that are often misdiagnosed and that can lead to severe

Francesca Scolamacchia; Ian G. Handel; Eric M. Fèvre; Kenton L. Morgan; Vincent N. Tanya; Barend M. de C. Bronsvoort; Igor Mokrousov

2010-01-01

298

The management of preauricular sinus.  

PubMed

Preauricular sinus is a common congenital condition which does not always cause symptoms. It is often misdiagnosed, can be difficult to treat surgically, and recurrences are common. The results of treatment in twelve Christchurch patients are discussed and a surgical technique is described. PMID:6581417

Hornibrook, J; Robertson, M S

1984-01-11

299

Arthroscopic decompression of an entrapped suprascapular nerve due to an ossified superior transverse scapular ligament: a case report  

Microsoft Academic Search

INTRODUCTION: Suprascapular neuropathy is an uncommon cause of shoulder pain and weakness and therefore is frequently misdiagnosed. As a consequence, misdiagnosis can include inappropriate conservative treatment or unsuccessful surgical procedure. CASE PRESENTATION: A rare case is reported of a 54-year-old woman who suffered from suprascapular nerve entrapment syndrome. The patient was subjected to arthroscopy of the left shoulder, where a

Neoptolemos N Sergides; Dimitrios D Nikolopoulos; Euangelos Boukoros; George Papagiannopoulos

2009-01-01

300

A plastic whistle incarcerated in bronchus diagnosed fourteen years after 'swallowed': a case report  

PubMed Central

Tracheobronchial foreign body aspiration (FBA) is a common disease in pre-school children but easily overlooked by physicians. In this article, we report a case with bronchial stenosis that is not typical and misdiagnosed for 14 years, in the end bronchoscopy retrieval was successfully performed after adequate preparation. Pitfalls and recommendations in diagnosis and management of FBA are briefly included.

Wang, Xin

2014-01-01

301

A Case of Renal Schwannoma  

PubMed Central

Schwannomas are benign tumors that arise from the neural sheath of Schwann cells. Renal schwannomas are extremely rare and are commonly misdiagnosed as renal cell carcinoma, which typically results in a radical nephrectomy. We present a case of a renal schwannoma that mimics a renal pelvis tumor.

Yang, Hee Jo; Lee, Min Ho; Kim, Doo Sang; Lee, Hyun Ju; Lee, Ji Hye

2012-01-01

302

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Consensus Statement on the Diagnosis and Management of Cyclic Vomiting Syndrome  

Microsoft Academic Search

Cyclic vomiting syndrome (CVS) is a disorder noted for its unique intensity of vomiting, repeated emergency department visits and hospitalizations, and reduced quality of life. It is often misdiagnosed due to the unappreciated pattern of recurrence and lack of confirmatory testing. Because no accepted approach to management has been established, the task force was charged to develop a report on

B UK Li; Frank Lefevre; Gisela G Chelimsky; Richard G Boles; Susanne P Nelson; Donald W Lewis; Steven L Linder; Robert M Issenman; Colin D Rudolph

2008-01-01

303

Severe postburn contracture of cheek mucosa leading to false temporomandibular joint ankylosis.  

PubMed

A case of burn injury to lips and cheek mucosa is reported who developed severe contracture of cheek mucosa leading to inability to open mouth. Patient was misdiagnosed as a case of temporomandibular ankylosis and was managed on those lines to no relief. When the contracture was released and soft tissue defect repaired with nasolabial flap, patient gained near normal mouth opening. PMID:16499819

Cheema, Saeed Ashraf; Amin, Farhat

2006-02-01

304

Psychogenic non-epileptic seizures: A challenging entity  

Microsoft Academic Search

Psychogenic non-epileptic seizures (PNES) are commonly encountered in neurologic practice. They are often misdiagnosed as epileptic seizures and treated as such for several years before a correct diagnosis is established. Such a misdiagnosis has the potential to expose patients to undue risk through several anti-epileptic drugs (AEDs). Patients are also affected in other ways, such as by financial consequences and

Kinshuk Sahaya; Swapan A. Dholakia; Pradeep K. Sahota

305

Biliary cystadenoma  

PubMed Central

The diagnosis of cystadenoma is rare, even more so when located in the extrahepatic bile duct. Unspecific clinical signs may lead this pathology to be misdiagnosed. The need for pathological anatomy in order to distinguish cystadenomas from simple biliary cysts is crucial. The most usual treatment nowadays is resection of the bile duct, together with cholecystectomy and Roux-en-Y reconstruction.

Bartolome, Miguel A Hernandez; Ruiz, Sagrario Fuerte; Romero, Israel Manzanedo; Lojo, Beatriz Ramos; Prieto, Ignacio Rodriguez; Alvira, Luis Gimenez; Carreno, Rosario Granados; Esteban, Manuel Limones

2009-01-01

306

Acoustic radiation force impulse (ARFI) imaging of preliminary mucosa associated lymphoid tissue (MALT) lymphoma in the breast: a case report  

PubMed Central

Primary lymphoma is a rare neoplasm in the breast accounting for between 0.04% and 0.5% of all malignant mammary tumors. The majority of cases lack typical features of breast malignancy or lymphoma, and likely to be misdiagnosed during daily clinical practice. In this report we describe a case of primary breast lymphoma assessed with acoustic radiation force impulse (ARFI) technology.

Chen, Jiexin; Jin, Zhanqiang; Deng, Dongli; Mao, Dongzhou; Li, Jianwen; Chen, Xiaodong; Ding, Hongfei

2013-01-01

307

Les fractures des épines tibiales chez l'enfant: à propos d'un cas  

Microsoft Academic Search

Mots-clés: Enfant; Epine tibiale; Fracture; Traitement Tibial spine fractures in children: a case report Summary Fractures of the tibial spine in children are rare. Those fractures can hide severe knee sprain. Diagnosis is made with the presence of hemarthrosis, knee pain and limb disability. Most often, thoses signs are variables in terms of intensity, so that fractures can be misdiagnosed

R. A. Randriambololona; H. J. C. Razafimahandry; H. N. Rakoto-Ratsimba; T. D. M. Andriantsoa; R. H. B. Randriarimanga; P. Lascombes

308

MIC failure analysis  

Microsoft Academic Search

Microbiologically influenced corrosion (MIC) can be misdiagnosed as attack caused by conventional chloride crevice or pitting corrosion unless specialized techniques are used during the failure analysis. These techniques include in situ bacteria sampling of residual water, bacterial analysis of corrosion products using analytical chemistry, culture growth, and scanning electron microscopy, as well as nondestructive examination using ultrasonic and radiographic techniques.

S. W. Borenstein; P. B. Lindsay

1994-01-01

309

Assessment of Pediatric Obsessive-Compulsive Disorder: A Critical Review of Current Methodology  

ERIC Educational Resources Information Center

Obsessive-compulsive disorder (OCD) is a relatively common disorder among children and adolescents, and is associated with increased risk for concurrent and future distress and impairment. Many youth who suffer from OCD go undiagnosed or misdiagnosed, and do not attain appropriate treatment in a timely manner. As a result, researchers have focused…

Merlo, Lisa J.; Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.

2005-01-01

310

Endometrial metaplasias and reactive changes: a spectrum of altered differentiation  

Microsoft Academic Search

Endometrial metaplasias and changes (EMCs) are conditions frequently overlooked and misdiagnosed. The aim of this review is to update current issues and provide a classification with a practical clinicopathological approach. Hormonal or irritative stimuli are the main inducing factors of EMCs, although some metaplasias have a mutational origin. EMCs vary from reactive, degenerative lesions to those able to associate with

Alina Nicolae; Ovidiu Preda; Francisco F Nogales

2010-01-01

311

Anxiety in Children and Adolescents with Autism Spectrum Disorders  

ERIC Educational Resources Information Center

Anxiety symptoms and disorders are highly prevalent in children and adolescents with Autism Spectrum Disorder (ASD), although they are often unrecognized or misdiagnosed. The purpose of the present review is to (1) provide clinicians with practical information on assessment and diagnosis of co-morbid anxiety in children and adolescents with ASD,…

MacNeil, Bonnie M.; Lopes, Vicki A.; Minnes, Patricia M.

2009-01-01

312

Encephalopathy, hearing loss and retinal occlusions (Susac's syndrome): a new case.  

PubMed

We describe a young woman with retinal arteriolar occlusions, encephalopathy, and hearing loss. At present this disorder is known as Susac's syndrome, a microangiopathy of the brain and retina whose pathogenesis is, however, unknown. The article reviews the clinical features of this rare, but not unusual, syndrome that can easily be misdiagnosed as multiple sclerosis. PMID:10933462

Maddestra, M; Sabatini, S; Paci, A

1998-08-01

313

Susac syndrome: serial diffusion-weighted MR imaging  

Microsoft Academic Search

Susac syndrome (SS) is a clinical triad of hearing loss, retinal artery occlusion and encephalopathy. The typical MR imaging findings of multiple focal lesions in the corpus callosum and subcortical white matter can be easily misdiagnosed as multiple sclerosis. On diffusion-weighted (DW) MR imaging, new lesions were hyperintense, with reduced apparent diffusion coefficient (ADC). These lesions later became less prominent

Mao Sheng Xu; Chai Beng Tan; T. Umapathi; C. C. Tchoyoson Lim

2004-01-01

314

An interesting case of dysautonomia presenting with dyspnea.  

PubMed

Dysautonomia such as POTS syndrome presenting with respiratory symptoms can often be misdiagnosed for other common pulmonary conditions. It can be diagnosed with a comprehensive history and orthostatic vital measurement. Simple diagnostic test such as diffusing capacity in supine and standing position can emerge as a noninvasive tool to guide the long-term monitoring and treatment response. PMID:23401321

Popatia, Rizwana; Subramaniam, Meera

2014-03-01

315

Thorotrast granuloma: an unexpected diagnosis.  

PubMed

An example of a Thorotrast granuloma (thorotrastoma) occurred in the neck of a patient 44 years after a carotid angiogram in which Thorotrast was used as radiological contrast medium. The lesion had produced a "cold" abscess and the patient was undergoing treatment for retropharyngeal tuberculosis. Thorotrast leakage can produce unusual clinical symptoms and signs which are frequently misdiagnosed. PMID:1556239

Polacarz, S V; Laing, R W; Loomes, R

1992-03-01

316

Volar lunate dislocation associated with a Salter-Harris Type III fracture of the distal radial epiphysis in an 8 year-old child.  

PubMed

Carpal fracture-dislocations in children are extremely rare injuries and are easily missed or misdiagnosed. An 8 year-old boy who presented with a volar lunate dislocation associated with a Salter Harris Type III injury of the distal radial epiphysis is reported. Open reduction without internal fixation followed by plaster immobilisation achieved good short-term results. PMID:17045369

Sharma, H; Azzopardi, T; Sibinski, M; Wilson, N

2007-02-01

317

Image contrast improvement with local weighting corrections from organ bio-distribution information by external TLD measurement in PET studies  

Microsoft Academic Search

Image contrast is frequently affected by the high radioactivity uptakes of source organs such as bladder and GI track in [F-18]FDG PET studies. Certain important tumors neighboring to these organs are potentially mis-diagnosed. The study is to propose a new approach to improve the image contrast by applying the local weighting factors obtained from the biodistribution information of the source

T. H. Wu; T. G. Chu; R. S. Liu; J. S. Lee

2001-01-01

318

Chlamydia, cytomegalovirus, and Yersinia in inflammatory bowel disease.  

PubMed

The relationship of three infectious agents, Chlamydia, cytomegalovirus, and Yersinia enterocolitica, to the aetiology, clinical course, and diagnosis of Crohn's disease was studied. There was no evidence of chlamydial infection in Crohn's disease and no indication either that cytomegalovirus alters the outcome of acute attacks or that infection with Y. enterocolitica is being misdiagnosed as Crohn's disease. PMID:87888

Swarbrick, E T; Kingham, J G; Price, H L; Blackshaw, A J; Griffiths, P D; Darougar, S; Buckell, N A

1979-07-01

319

Lyme Disease: Implications for Health Educators.  

ERIC Educational Resources Information Center

Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

Harbit, Maryanne Drake; Willis, Dawn

1990-01-01

320

Orbital Rosai-Dorfman Disease in a Five-Year-Old Boy  

PubMed Central

Rosai–Dorfman disease (RDD) is characterized by histiocytic proliferation and massive cervical lymphadenopathy, although some patients have extra-nodal involvement. We report a case of extranodal RDD in a five-year-old child, initially misdiagnosed as orbital inflammatory disease and treated with oral steroids. A subsequent orbital biopsy three years later confirmed the diagnosis of Rosai Dorfman disease.

Al-Moosa, Ashref J.; Behbehani, Raed S.; Hussain, Abdulmohsen E.; Ali, Abdullah E.

2011-01-01

321

Vaginal lichen planus: preservation of sexual function in severe disease  

PubMed Central

Lichen planus is a multisystem disease. Often genital involvement is missed or misdiagnosed. It can be rapidly progressive with high patient morbidity. This case highlights the importance of a multidisciplinary approach and the effectiveness of combined surgical and medical treatment with close patient follow-up and support.

Machin, Sarah E; McConnell, Dynes T; Adams, John D

2010-01-01

322

Acute ECG ST-segment elevation mimicking myocardial infarction in a patient with pulmonary embolism  

Microsoft Academic Search

Pulmonary embolism is a common cardiovascular emergency, but it is still often misdiagnosed due to its unspecific clinical symptoms. Elevated troponin concentrations are associated with greater morbidity and mortality in patients with pulmonary embolism. Right ventricular ischemia due to increased right ventricular afterload is believed to be underlying mechanism of elevated troponin values in acute pulmonary embolism, but a paradoxical

Tomaž Goslar; Matej Podbregar

2010-01-01

323

Rescuing Troubled Software Projects by Team Transformation: A Case Study With an ERP Project  

Microsoft Academic Search

Many software projects fail, whether failure is measured in terms of budget, schedule, or some other requirement. The causes of such failures are many, but are not always easily recognized. This is not the least due to the human dimension of corporate activities, as spurious or misdiagnosed issues in Enterprise Resource Planning (ERP) projects can take on a life of

Kim Man Lui; Keith C. C. Chan

2008-01-01

324

Neutrophil to lymphocyte ratio for preoperative diagnosis of uterine sarcomas: A case-matched comparison  

Microsoft Academic Search

BackgroundUterine sarcomas are rare among all uterine malignancies, and frequently misdiagnosed as benign uterine diseases such as leiomyoma and adenomyosis because of lack of feasible tools for the preoperative diagnosis. Although some studies have suggested the role of serum CA-125 levels for the preoperative diagnosis, the efficacy is controversial. Since malignancy is known to be associated with systemic inflammation which

H. S. Kim; K. H. Han; H. H. Chung; J. W. Kim; N. H. Park; Y. S. Song; S. B. Kang

2010-01-01

325

Sarcoidosis of the cauda equina mimicking leptomeningeal malignancy  

Microsoft Academic Search

Isolated neurosarcoidosis can present with a wide range of central nervous system manifestations. We present two cases of cauda equina sarcoidosis misdiagnosed initially as leptomeningeal malignancy, and review the literature. This unusual manifestation of neurosarcoidosis is typified by an indolent, chronic process with limited response to corticosteroid therapy.

Lauren E. Abrey; Marc K. Rosenblum; Lisa M. DeAngelis

1998-01-01

326

Tubes, lines, catheters, and other interesting devices  

Microsoft Academic Search

Medical devices (tubes, catheters, lines, prostheses, etc.) are a common finding on radiologic studies. Sometimes they may be misdiagnosed as a pathologic process, or an important observation concerning a medical device may be overlooked because of lack of familiarity with a particular device. This review discusses a variety of tubes, lines, catheters, and other interesting and important medical devices found

Tim B. Hunter

1995-01-01

327

Extraskeletal osteosarcoma: a case report.  

PubMed

Extraskeletal osteosarcoma is a rare soft tissue sarcoma. Survival is related with the wide resection of the tumor. The role of adjuvant chemotherapy and radiation therapy remains controversial. In our study, we present a patient with extraskeletal osteosarcoma of the thigh which was initially misdiagnosed as lipoma. PMID:22659628

Mavrogenis, Andreas F; Papadogeorgou, Ellada; Papagelopoulos, Panayiotis J

2012-01-01

328

Empirically Informed Attention-Deficit/Hyperactivity Disorder Evaluation with College Students  

ERIC Educational Resources Information Center

Attention-deficit/hyperactivity disorder (ADHD) is both an underdiagnosed and a misdiagnosed problem on college campuses, leading to pronounced academic and psychosocial difficulties. Counselors encounter diagnostic criteria that are child oriented, long lists of differential diagnoses, high rates of coexisting disorders, and no definitive tests…

Reilley, Sean P.

2005-01-01

329

Metoclopramide-induced oculogyric crisis presenting as encephalitis in a young girl  

PubMed Central

Drug-related dystonic reactions are not uncommon and often misdiagnosed as encephalitis, seizures, tetanus, tetany, etc. Eliciting thorough history is important to avoid unnecessary investigations and treatments as these are potentially reversible reactions. Metoclopramide-induced oculogyric crisis is described in this case report.

Arumugam, Jayavardhana; Vijayalakshmi, A.M.

2012-01-01

330

SVM-Based Multiclass Cost-sensitive Classification with Reject Option for Fault Diagnosis of Steam Turbine Generator  

Microsoft Academic Search

The steam turbine generator faults not only damage the generator itself, but also cause outages and loss of profits, for this reason, many researchers work on the fault diagnosis. But misdiagnosing may also lead to serious losses. In order to improve the diagnosis reliability and reduce the loss caused by misdiagnosis, in this paper, cost integrated multiclass SVM with reject

Chao Zou; En-hui Zheng; Hong-wei Xu; Le Chen

2010-01-01

331

Hemophagocytic [corrected] lymphohistiocytosis associated with nephrotic syndrome and multi-organ failure.  

PubMed

Hemophagocytic lymphohistiocytosis (HLH) is still an important elusive and misdiagnosed condition despite of improved knowledge. Nephrotic syndrome associated with HLH is not a common feature and has been rarely reported in hemophagocytic syndrome. We report a 27-year-old man with HLH who progressed to multi-organ failure as well as nephrotic-range proteinuria, generalized edema, and hypoalbuminemia. PMID:23146987

Alavi Darazam, Ilad; Sami, Ramin; Ghadir, Maliheh; Mohammadi, Forouzan; Rashid Farokhi, Farin; Mansouri, Davood; Nassiri, Amir Ahmad

2012-11-01

332

Tracheal web.  

PubMed

Congenital tracheal web is a rare entity often misdiagnosed as refractory asthma. Clinical suspicion based on patient history, examination, and pulmonary function tests should lead to its consideration. Bronchoscopy combined with CT imaging and multiplanar reconstruction is an accepted, highly sensitive means of diagnosis. PMID:14586524

Legasto, Alan C; Haller, Jack O; Giusti, Robert J

2004-03-01

333

Diagnosis and neuroimaging of acute stroke producing distal arm monoparesis  

Microsoft Academic Search

Strokes which result in the isolated, pure motor weakness of an upper extremity are unusual and under-recognized cerebrovascular syndromes. Few reports in the literature describe the syndrome adequately or provide substantive clinical or anatomical correlation. Moreover, it may be misdiagnosed as a disorder of the peripheral nervous system because of the lack of pyramidal tract signs or the involvement of

John Castaldo; Joanne Rodgers; Alexander Rae-Grant; Peter Barbour; Donna Jenny

2003-01-01

334

Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam  

Microsoft Academic Search

BACKGROUND: Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengue, are the main causes of undifferentiated fever but they are often misdiagnosed and inappropriately treated

Hoang L Phuong; Tran TT Nga; Phan T Giao; Le Q Hung; Tran Q Binh; Nguyen V Nam; Nico Nagelkerke; Peter J de Vries

2010-01-01

335

Lacrimal canaliculitis  

PubMed Central

Canaliculitis is an uncommon, often misdiagnosed diagnosis because canaliculitis can mimic many other common ocular conditions. Canaliculitis should be appropriately diagnosed and treated to avoid recurrent inflammation and possible obstruction of the upper portion of the lacrimal system. This review will serve as a concise resource to aid in diagnosis and provide updated management options.

Zaveri, Jill; Cohen, Adam J.

2013-01-01

336

A Patient Presenting with Concurrent Testis Torsion and Epididymal Leiomyoma  

PubMed Central

Leiomyomas are the second most common tumors of epididymis. Patients with leiomyomas are sometimes misdiagnosed with testicular tumors. A Case of a patient with a scrotal mass presenting with testicular torsion is reported. Concurrent occurrence of testicular torsion and epididymal leiomyoma is an extremely rare condition.

Arpali, E.; Tok, A.

2013-01-01

337

A young man with altered mental status and new-onset seizures.  

PubMed

Signs and symptoms of a subacute, progressive, imaging-negative encephalopathy can be misdiagnosed as a neuropsychiatric or progressive neurodegenerative disorder. However, encephalopathies often can be reversed if the autoimmune component is recognized early through a careful history and diagnostic testing, including cerebrospinal fluid analysis for antibodies. PMID:24201920

Cassa, Richard S; Rosengart, Axel J

2013-10-01

338

Unrecognized medical emergencies admitted to psychiatric units  

Microsoft Academic Search

Alteration of mental status secondary to medical illness may occasionally be incorrectly attributed to a psychiatric problem. The cases of 64 patients with unrecognized medical emergencies inappropriately admitted to psychiatric units from emergency departments were reviewed to determine the cause of the misdiagnoses. Medical diagnoses most often missed included severe intoxication with alcohol or other illicit substance (34.4%), drug or

Roy R. Reeves; Eric J. Pendarvis; Ray Kimble

2000-01-01

339

Cornual ectopic pregnancy in a female with initial negative ultrasound.  

PubMed

Cornual pregnancies are a rare form of ectopic pregnancy that can be misdiagnosed as an intrauterine pregnancy via ultrasound. We report a 16-year-old adolescent girl with a cornual ectopic pregnancy and subsequent rupture in the emergency department. PMID:22158281

Gutierrez, Peter S; Lewis, Madeline; Barabell, Gregory; Upshaw, Jana

2011-12-01

340

Benign nontraumatic inflammatory stricture of mid portion of common bile duct mimicking malignant tumor: Report of two cases  

Microsoft Academic Search

Benign nontraumatic inflammatory stricture of the common bile duct (CBD) may result in obstructive jaundice, which can be misdiagnosed as a malignant tumor of the CBD preoperatively. Two cases with strictures of the mid portion of the common bile duct presenting with obstructive jaundice are reported herein. Preoperative radiological studies prompted us to confidently make the diagnosis of cholangiocarcinoma. However,

Chiu-Yung Ho; Tseng-Shing Chen; Full-Young Chang; Shou-Dong Lee

341

Complete Right Lung Agenesis with Dextrocardia: An Unusual Cause of Respiratory Distress  

PubMed Central

Pulmonary agenesis, defined as complete absence of bronchus, parenchyma, and vessels is a very rare condition. Herein, we report a 4-month-old infant who presented with fever, cough, and respiratory distress and was misdiagnosed in a peripheral hospital as a case of pneumonia. The child was, later diagnosed as having right lung agenesis with dextrocardia.

Nandan, Devki; Bhatt, Girish Chandra; Dewan, Vivek; Pongener, Imkongkumzuk

2012-01-01

342

Full Body Gait Analysis May Improve Diagnostic Discrimination Between Hereditary Spastic Paraplegia and Spastic Diplegia: A Preliminary Study  

ERIC Educational Resources Information Center

Hereditary spastic paraplegia (HSP) and spastic diplegia (SD) patients share a strong clinical resemblance. Thus, HSP patients are frequently misdiagnosed with a mild form of SD. Clinical gait analysis (CGA) has been highlighted as a possible tool to support the differential diagnosis of HSP and SD. Previous analysis has focused on the lower-body…

Bonnefoy-Mazure, A.; Turcot, K.; Kaelin, A.; De Coulon, G.; Armand, S.

2013-01-01

343

Prevalence and Outcomes of Restless Legs Syndrome Among Veterans.  

National Technical Information Service (NTIS)

Restless Legs Syndrome (RLS) is a commonly under or misdiagnosed organic cause of insomnia. Prevalence estimates range form 4 to 16%, with 29% reported among Veterans. Thirty-five percent of US adults report insomnia annually. There is evidence that insom...

C. C. Bourguet

2004-01-01

344

A case of peduncular hallucinosis presenting as a primary psychiatric disorder.  

PubMed

Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder. PMID:24339609

Dogan, Vasfiye Burcu; Dirican, Ayten; Koksal, Ayhan; Baybas, Sevim

2013-10-01

345

Lipedema, a frequently unrecognized problem.  

PubMed

Lipedema is characterized by symmetric lower extremity enlargement secondary to the deposition of fat. Lipedema is not rare, but it is commonly misdiagnosed as lymphedema. We describe a 20-year-old woman with massive lower extremity enlargement that did not respond to compression therapy. Magnetic resonance imaging of the lower extremities helped to confirm the diagnosis. PMID:17637360

Fonder, Margaret A; Loveless, James W; Lazarus, Gerald S

2007-08-01

346

Epithelioid sarcoma of the penis—a rare differential diagnosis of Peyronie's disease  

Microsoft Academic Search

We report on a case of penile epithelioid sarcoma in a 29-year-old man presenting with a dorsal penile plaque that primarily was misdiagnosed as Peyronie's disease. Although the initial clinical findings of these two different entities appear similar, the consequence for the patient is severe. The only way of differentiating these disorders are histological findings. The principal microscopic characteristics of

E W Hauck; H U Schmelz; T Diemer; N Hackstein; K Fenchel; W Weidner; B Knoblauch

2003-01-01

347

Burkitt's lymphoma mimicking EBV disease as first sign of vertical HIV infection in an adolescent  

PubMed Central

Burkitt's Lymphoma (BL) rarely represents the first clinical manifestation of vertical HIV infection in adolescent in Western Europe. We report the case of a 17 year-old boy with two week history of fever and enlarged cervical lymph nodes firstly misdiagnosed as EBV infection, subsequently diagnosed as Burkitt's Lymphoma and vertical HIV infection.

2010-01-01

348

Pancreatitis in the dog:. dealing with a spectrum of disease  

Microsoft Academic Search

PANCREATITIS - whether it be acute or chronic - is a relatively common, but often misdiagnosed, problem in dogs. It is associated with a systemic inflammatory response which, in severe cases, can result in the development of multiorgan failure, diffuse intravascular coagulation and death. Classical acute pancreatitis is often straightforward to diagnose, but this only represents one end of a

Penny Watson

2004-01-01

349

Laboratory-acquired Brucellosis  

PubMed Central

We report two laboratory-acquired Brucella melitensis infections that were shown to be epidemiologically related. Blood culture isolates were initially misidentified because of variable Gram stain results, which led to misdiagnoses and subsequent laboratory exposures. Notifying laboratory personnel who unknowingly processed cultures from brucellosis patients is an important preventive measure.

Gallo, Richard; Kelly, Molly; Limberger, Ronald J.; DeAngelis, Karen; Cain, Louise; Wallace, Barbara; Dumas, Nellie

2004-01-01

350

Vulval tuberculosis - an unusual presentation of disseminated tuberculosis.  

PubMed

Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis. Vulval TB is very rare and the presentation can be quite variable, and may be misdiagnosed as sexually transmitted disease. We herein report a young lady with disseminated TB presenting as Vulval TB. PMID:23781671

Nanjappa, Veena; Suchismitha, R; Devaraj, H S; Shah, Mihir B; Anan, Anju; Rahim, Shani N

2012-12-01

351

Anatomy of pudendal nerve at urogenital diaphragm—new critical site for nerve entrapment  

Microsoft Academic Search

ObjectivesTo investigate the relations of the pudendal nerve in this complex anatomic region and determine possible entrapment sites that are accessible for surgical decompression. Entrapment neuropathies of the pudendal nerve are an uncommon and, therefore, often overlooked or misdiagnosed clinical entity. The detailed relations of this nerve as it exits the pelvis through the urogenital diaphragm and enters the mobile

Stephan Hruby; Johannes Ebmer; A. Lee Dellon; Oskar C. Aszmann

2005-01-01

352

A Preliminary Report on the English Phonology of Typically Developing English-Mandarin Bilingual Preschool Singaporean Children  

ERIC Educational Resources Information Center

Background: There are no published data on typical phonological development for Singaporean children. There is therefore the risk that children's speech in Singapore may be misdiagnosed or that clinicians may set goals erroneously. Aims: This paper reports a preliminary study on the English phonology of typically developing 4;0-4;5-year-old…

En, Lydea Gn Wei; Brebner, Chris; McCormack, Paul

2014-01-01

353

“The Malignant Wart”: A Review of Primary Nodular Melanoma of the Foot and Report of Two Cases  

Microsoft Academic Search

The reported incidence of melanoma is rapidly rising and second only to lung cancer. Primary melanoma of the lower extremity accounts for approximately 30% of all cases reported, with half of these cases localized to the foot itself. Unfortunately, melanoma can be misdiagnosed and treatment delayed, as they are usually not painful. The overall 5- and 10-year survival rates improve

Valerie L. Schade; Thomas S. Roukis; Joseph F. Homann; Tommy Brown

2010-01-01

354

Brief Education About Autism Spectrum Disorders for Family Therapists  

Microsoft Academic Search

The prevalence of autism spectrum disorders (ASDs) is on the rise, and family therapists are increasingly likely to encounter clients who have some form of this disorder. There is emerging evidence that professionals, including family therapists, may misdiagnose the condition or that proper diagnosis and treatment may be delayed. Thus, professional education about ASDs is important. In addition to the

Kay Bradford

2010-01-01

355

Urinary Infection  

Microsoft Academic Search

For further cytomicrobiological analysis correct urine collection is required because, in women, there is the possibility of contaminating the urine sample at micturition by the saprophyte flora of the vagina. In men, preputial hypertrophy and the germs growing on the prepuce, especially in the smegma, can cause false analytical results which may lead to misdiagnoses and inadequate treatment. To avoid

A. Puigvert

1986-01-01

356

Filaroides osleri ( Oslerus osleri): Two case reports and a review of canid infections in North America  

Microsoft Academic Search

Infections of domesticated dogs by a worldwide parasitic nematode Filaroides osleri (Oslerus osleri) lead to verminous tracheobronchitis that are often misdiagnosed clinically as kennel cough, due to infection with the bacterium Bordetella bronchiseptica. Diagnosis of two canine cases in Wyoming, USA prompted a search of the literature of canid infections in North America. Infections of domestic dogs are reported in

Chaoqun Yao; Donal O’Toole; Mike Driscoll; Warner McFarland; Jonathan Fox; Todd Cornish; William Jolley

2011-01-01

357

Pólipo fibroepitelial estromal vulvo-vaginal y de cérvix  

Microsoft Academic Search

SUMMARY Vulvovaginal fibroepithelial polyp is a benign condition frequently misdiagnosed as malignant despite the fact that this entity is well-known in the literature. The variety of histopathological pat- terns is the most important characteristic. In this article we report a series of nineteen cases and review the literature.

Alejandro José Martínez Torrano; Luis Alberto Polo García; Belén Ferri Ñiguez; Emma Iborra Lacal; Joaquín Sola Pérez

358

Iatrogenic tracheal stenosis presenting as persistent asthma.  

PubMed

Although the incidence of post-intubation tracheal stenosis has markedly decreased with the advent of large volume, low pressure endotracheal tube cuffs, it still occurs, commonly in patients after prolonged intubation. We report a case of tracheal stenosis that developed after a brief period of endotracheal intubation, and that was misdiagnosed and treated as asthma and panic attacks. PMID:23345469

Barreiro, Timothy J; Ghattas, Christian; Valino, Cherry Ann

2013-09-01

359

Soft tissue neck lumps in rugby union players  

Microsoft Academic Search

Dorsal neck masses are well recognised in front row rugby union players. Previously undescribed in the medical literature, they may present in the primary or secondary care setting when they become symptomatic. Often misdiagnosed as lipomata, they may in fact be fibrous and deeply connected, with the consequences of embarking on surgery subsequently underestimated. This paper describes an epidemiological study

J Dearing

2006-01-01

360

Celiac Disease and Lymphoma Risk: A Multicentric Case–Control Study in Spain  

Microsoft Academic Search

Celiac disease is a highly prevalent condition frequently misdiagnosed because of heterogeneity of the clinical symptoms. It is well recognized that enteropathy-associated T-cell lymphoma is an uncommon lymphoma type linked to celiac disease; it has also been suggested that other types of lymphomas may be associated with celiac disease. Our aim was to estimate the risk of all lymphoma associated

Carme Farré; Eva Domingo-Domenech; Teresa Marques; Alberto Fernandez De Sevilla; Tomas Alvaro; Mercedes Garcia Villanueva; Vicens Romagosa; Silvia De Sanjose

2004-01-01

361

Kirit C. Shah, M.D. v. Stan Harris and Nancy Harris. "Construction of Legal Arguments, Statutes of Limitations, and Medical Malpractice." Lesson Plans for Secondary Teachers on How Lawyers Prepare Their Arguments. Courts in the Classroom: Curriculum Concepts and Other Information on Indiana's Courts for the K-12 Educator.  

ERIC Educational Resources Information Center

Stan and Nancy Harris filed a complaint against Kirit C. Shah, M.D., for misdiagnosing Mr. Harris's illness, charging Dr. Shah with negligence and asking for damages. A medical malpractice action in Indiana is governed by a two year statute of limitations. Because the Harrises failed to bring their action against Dr. Shah within this two year…

Osborn, Elizabeth

362

Identifying Hearing Loss in Young Children: Technology Replaces the Bell  

ERIC Educational Resources Information Center

Hearing loss can too easily be misdiagnosed or overlooked by providers serving young children. Parents and professionals may observe a language delay--an "invisible" condition--while failing to identify the underlying cause. Otoacoustic emissions (OAE) hearing screening technology, used extensively with newborns, is becoming an essential tool,…

Eiserman, William; Shisler, Lenore

2010-01-01

363

Optimal Outcome in Individuals with a History of Autism  

ERIC Educational Resources Information Center

Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a…

Fein, Deborah; Barton, Marianne; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael; Helt, Molly; Orinstein, Alyssa; Rosenthal, Michael; Troyb, Eva; Tyson, Katherine

2013-01-01

364

Fever with rash in patients returning from popular tourist resort Phuket, Thailand: dengue--or measles?  

PubMed

We report three recent cases of measles in travelers to a popular vacation resort, Phuket, Thailand, two initially diagnosed clinically as dengue, one as drug reaction. In countries with no indigenous measles, clinicians may no longer recognize the disease. When left misdiagnosed, the patients continue to be potential transmitters. PMID:22943274

Kantele, Anu; Mattila, Leena; Ott, Kristi; Davidkin, Irja; Siikamäki, Heli

2012-01-01

365

Spirit Possession and Exorcism in the Treatment of a Bedouin Psychiatric Patient  

Microsoft Academic Search

A male Bedouin psychiatric patient was initially misdiagnosed and treated as a paranoid schizophrenic. The modern mental health care system correctly understood the “form” of the patient's symptoms, auditory and visual hallucinations. It did not however at first appreciate their “content”, or cultural significance. The patient had unresolved anger toward his family which was manifested in an angry exchange with

Alean Al-Krenawi; John R. Graham

1997-01-01

366

Prurigo pigmentosa: a report of two cases that responded to minocycline.  

PubMed

Prurigo pigmentosa (PP) is an unusual pruriginous dermatosis of unknown aetiology and is often misdiagnosed. We report two people (a 16-year-old Chinese boy and a 21-year-old Chinese woman), who presented with clinicopathological features consistent with PP. Both patients were successfully treated with minocycline. Better knowledge of this disease will lead to early recognition and appropriate treatment. PMID:19489866

Chiam, L Y T; Goh, B K; Lim, K S; Ng, S K

2009-12-01

367

Solitary fibrous tumor (SFT) of the pelvis  

Microsoft Academic Search

Solitary fibrous tumors (SFTs) are well recognized in the pleura, but their occurrence at other sites has only become appreciated in recent years, as a consequence of which extrapleural examples often go unrecognized and misdiagnosed. Because of their rarity, overall experience concerning this tumor has not been significant and reports detailing radiological findings are few. We herein report an unusual

Shiu Yan J. Wat; Monalisa Sur; Kavita Dhamanaskar

2008-01-01

368

Living with the Active Alert Child: Groundbreaking Strategies for Parents. Third Edition.  

ERIC Educational Resources Information Center

Bright, controlling, fearful, and highly energetic, active alert children are frequently misdiagnosed as hyperactive or learning disabled. This book offers guidance for the special challenge of parenting the active alert infant, child, and adolescent. Part 1 of the book profiles the active alert child and examines 11 traits that characterize…

Budd, Linda S.

369

Quantitative Assessment of Brainstem Development in Joubert Syndrome and Dandy-Walker Syndrome  

Microsoft Academic Search

Key features of Joubert syndrome include developmental delay, hypotonia, hyperpnea and apnea, oculomotor apraxia, and the presence of the molar tooth sign on axial imaging through the brainstem isthmus—the junction of the pons and mesencephalon. Interestingly, 1 in 10 patients with Joubert syndrome has abnormal cerebrospinal fluid collections misdiagnosed as Dandy-Walker variants. Because of important differences in patient management, genetic

Bernard L. Maria; Alilreza Bozorgmanesh; Kimberly N. Kimmel; Douglas Theriaque; Ronald G. Quisling

2001-01-01

370

Differentiating Conduct Disorder from Depressive Disorders in School Age Children.  

ERIC Educational Resources Information Center

Due to similarities in symptomatology, childhood depression has often been misdiagnosed as conduct disorder. Differentiating between the two disorders would help to direct the appropriate interventions for each disorder. Children (N=48) between the ages of 6 and 13 years and their parents participated in a study designed to analyze variables which…

King, Richard B.; And Others

371

Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of I-123-MIBG–SPECT  

Microsoft Academic Search

Background: Differential diagnosis between idiopathic Parkinson’s disease (PD) and multiple system atrophy (MSA) is often difficult in early disease stages. Since MSA is misdiagnosed as PD in more than 20% of the early stages, there is need for methods refining the differentiation of the two disease entities. In PD postganglionic involvement of the autonomic nervous system (ANS) predominates whereas in

A Druschky; M. J Hilz; G Platsch; M Radespiel-Tröger; K Druschky; T Kuwert; B Neundörfer

2000-01-01

372

Circadian rhythm sleep disorders (CRSD)  

Microsoft Academic Search

Circadian Rhythm Sleep Disorders (CRSD) are a group of sleep disorders characterized by a malsynchronization between a person's biological clock and the environmental 24-h schedule. These disorders can lead to harmful psychological and functional difficulties and are often misdiagnosed and incorrectly treated due to the fact that doctors are unaware of their existence. In the following review we describe the

Yaron Dagan

2002-01-01

373

Cutaneous Gnathostomiasis with Recurrent Migratory Nodule and Persistent Eosinophilia: a Case Report from China  

PubMed Central

The present study reports a human case of cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia in China. A 52-year-old woman from Henan Province, central China, presented with recurrent migratory reddish swelling and subcutaneous nodule in the left upper arm and on the back for 3 months. Blood examination showed eosinophila (21.2%), and anti-sparganum antibodies were positive. Skin biopsy of the lesion and histopathological examinations revealed dermal infiltrates of eosinophils but did not show any parasites. Thus, the patient was first diagnosed as sparganosis; however, new migratory swellings occurred after treatment with praziquantel for 3 days. On further inquiring, she recalled having eaten undercooked eels and specific antibodies to the larvae of Gnathostoma spinigerum were detected. The patient was definitely diagnosed as cutaneous gnathostomiasis caused by Gnathostoma sp. and treated with albendazole (1,000 mg/day) for 15 days, and the subsequent papule and blister developed after the treatment. After 1 month, laboratory findings indicated a reduced eosinophil count (3.3%). At her final follow-up 18 months later, the patient had no further symptoms and anti-Gnathostoma antibodies became negative. Conclusively, the present study is the first report on a human case of cutaneous gnathostomiasis in Henan Province, China, based on the past history (eating undercooked eels), clinical manifestations (migratory subcutaneous nodule and persistent eosinophilia), and a serological finding (positive for specific anti-Gnathostoma antibodies).

Cui, Jing; Wang, Ye

2013-01-01

374

Praziquantel Treatment in Trematode and Cestode Infections: An Update  

PubMed Central

Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried.

2013-01-01

375

Parasitic infections based on 320 clinical samples submitted to hanyang university, Korea (2004-2011).  

PubMed

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook; Ahn, Myoung-Hee

2014-04-01

376

[Helminth diagnosis in pathologic anatomy].  

PubMed

Most publications devoted to diagnosis of helminths emphasize characteristic parasitological features. Histological feature are seldom described in detail. The purpose of this study was to propose a diagnostic method suitable for use by histologists who, unlike parasitologists, do not visualize the whole worm but rather pieces randomly scattered over a slide. It is relatively easy to distinguish helminths which have smooth muscle, no respiratory or circulatory system, and no coelom from arthropods which have striated muscle, both respiratory and circulatory systems, and coelom. At the adult stage, roundworms or nemathelminths present an external cuticle that may have patterned markings. The visceral cavity is empty. Adults can dwell either in the intestine in which case they are oviparous (oxyuris, ascaris, Ancylostoma, Strongyloides stercoralis, Trichuris...) or in tissue in which case they are viviparous (filaria). Larva of some species can be found in tissues. Adult tape-worms are devoid of cuticle and have a mesenchymatous visceral cavity. Cestodes which are segmented and have no digestive tract (taenias) are readily distinguishable from trematodes which are not segmented and have a digestive tract (faciolasis) Some cestodes unable thrive in man can cause cyst formation (hydatidosis, sparganosis, cysticercosis, coenurosis). On the basis of symptoms and histological features, it is usually possible to diagnose the genus and even the species of the offending helminth provided that the parasite has not been excessively damaged and that a sufficient number of sections are available. PMID:9718562

Pierre, C; Civatte, M; Chevalier, A; Terrier, J P; Gros, P; Carloz, E

1998-01-01

377

Zoonotic helminths affecting the human eye  

PubMed Central

Nowaday, zoonoses are an important cause of human parasitic diseases worldwide and a major threat to the socio-economic development, mainly in developing countries. Importantly, zoonotic helminths that affect human eyes (HIE) may cause blindness with severe socio-economic consequences to human communities. These infections include nematodes, cestodes and trematodes, which may be transmitted by vectors (dirofilariasis, onchocerciasis, thelaziasis), food consumption (sparganosis, trichinellosis) and those acquired indirectly from the environment (ascariasis, echinococcosis, fascioliasis). Adult and/or larval stages of HIE may localize into human ocular tissues externally (i.e., lachrymal glands, eyelids, conjunctival sacs) or into the ocular globe (i.e., intravitreous retina, anterior and or posterior chamber) causing symptoms due to the parasitic localization in the eyes or to the immune reaction they elicit in the host. Unfortunately, data on HIE are scant and mostly limited to case reports from different countries. The biology and epidemiology of the most frequently reported HIE are discussed as well as clinical description of the diseases, diagnostic considerations and video clips on their presentation and surgical treatment. Homines amplius oculis, quam auribus credunt Seneca Ep 6,5 Men believe their eyes more than their ears

2011-01-01

378

Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)  

PubMed Central

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples.

Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook

2014-01-01

379

Description of Hemicaloosia graminis n. sp. (Nematoda: Caloosiidae) Associated with Turfgrasses in North and South Carolina, USA  

PubMed Central

A new nematode species was discovered during a diversity survey of plant-parasitic nematodes on turfgrass conducted in North and South Carolina in 2010 and 2011. It is described herein as Hemicaloosia graminis n. sp. and is characterized by two annuli in the lip region, one lateral line, body 610.0–805.0 ?m long, stylet 65.0–74.6 ?m long, vulva at 84.1% –85.8% of the body , 254–283 annuli, vulva at the 38–53rd annulus from tail terminus, 12–14 annuli between vulva and anus, tail elongate-pointed, 67.5–84.8 ?m long in females and spicule straight, 31.0 ?m long, caudal alae well developed, two lateral lines in males. The newly described species is morphologically closest to H. paradoxa, but has a longer stylet (65.0–74.6 vs 61.0–65.0 ?m) and a higher V-value (84.1–85.8 vs 78.1–84.0%), less RV (38–53 vs 50–56), higher RVan (12–14 vs 10) in females, and a shorter tail (30.1 vs 36.7 ?m) and more anteriorly located excretory pore (105.9 vs 140.0 ?m) in the male. It was easily differentiated from other species based on near-full-length small subunit rRNA gene (SSU) and ITS1 sequences. Phylogenetic analysis from SSU supports placement in a monophyletic clade with the genus Caloosia. An identification key and a table of distinguishing characteristics are presented for all seven species of Hemicaloosia.

Zeng, Yongsan; Ye, Weimin; Tredway, Lane; Martin, Samuel; Martin, Matt

2012-01-01

380

Tomotherapy - a different way of dose delivery in radiotherapy  

PubMed Central

Aim of the study Helical tomotherapy is one of the methods of radiotherapy. This method enables treatment implementation for a wide spectrum of clinical cases. The vast array of therapeutic uses of helical tomotherapy results directly from the method of dose delivery, which is significantly different from the classic method developed for conventional linear accelerators. The paper discusses the method of dose delivery by a tomotherapy machine. Moreover, an analysis and presentation of treatment plans was performed in order to show the therapeutic possibilities of the applied technology. Dose distributions were obtained for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, tongue cancer, metastases to bones, and advanced skin cancer. Tomotherapy treatment plans were compared with conventional linear accelerator plans. Results Following the comparative analysis of tomotherapy and conventional linear accelerator plans, in each case we obtained the increase in dose distribution conformity manifested in greater homogeneity of doses in the radiation target area for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, metastases to bones, and advanced skin cancer, and the reduction of doses in organs at risk (OAR) for anaplastic medulloblastoma, vulva cancer, tongue cancer, and advanced skin cancer. The time of treatment delivery in the case of a tomotherapy machine is comparable to the implementation of the plan prepared in intensity-modulated radiotherapy (IMRT) technique for a conventional linear accelerator. In the case of tomotherapy the application of a fractional dose was carried out in each case during one working period of the machine. For a conventional linear accelerator the total value of the fractional dose in the case of anaplastic medulloblastoma and metastases to bones was delivered using several treatment plans, for which a change of set-up was necessary during a fraction. Conclusion The obtained results confirm that tomotherapy offers the possibility to obtain precise treatment plans together with the simplification of the therapeutic system.

Skorska, Malgorzata; Jodda, Agata; Ryczkowski, Adam; Kazmierska, Joanna; Adamska, Krystyna; Karczewska-Dzionk, Aldona; Zmijewska-Tomczak, Malgorzata; Wlodarczyk, Hanna

2012-01-01

381

Post-irradiation carcinosarcoma of uterus--a case report.  

PubMed

The carcinosarcoma (malignant mixed mullerian tumour) of uterus is an aggressive neoplasm composing of malignant glands in the malignant stroma showing biphasic appearance. A 55 year old woman presented with discharge per vaginum of one month duration. Earlier she was given radiotherapy for squamous cell carcinoma of vulva, six years back. Abdominal examination was insignificant. USG suggested presence of post-radiation effect with uterine mass. Panhysterectomy was done and on histopathology, the diagnosis of carcinosarcoma (heterologous variant) was made. The case is being reported and discussed. PMID:17183854

Sharma, A Barindra; Pukhrambam, Gayatri; Laishram, Sharmila

2006-10-01

382

Vulvitis circumscripta plasmacellularis (Zoon's vulvitis) associated with autoimmune polyglandular endocrine failure.  

PubMed

Vulvitis circumscripta plasmacellularis (Zoon's vulvitis) is a distinct clinicopathological entity which presents as a shiny, atrophic, erythematous plaque of the vulva. It is an idiopathic condition with characteristic clinical and histological findings that generally occur in isolation of other medical disorders. We report a 36-year-old woman with vulvitis circumscripta plasmacellularis associated with polyglandular endocrine failure and circulating autoimmune antibodies. The association between Zoon's vulvitis and these autoimmune conditions raises the possibility that Zoon's vulvitis may be an autoimmune disorder. PMID:8977726

Salopek, T G; Siminoski, K

1996-12-01

383

Angiolipoma of the labia majora: MR imaging findings with histopathological correlation.  

PubMed

Benign soft tissue tumors of the vulva are relatively rare in adult patients. We present the magnetic resonance (MR) imaging features of an angiolipoma of the labia majora that developed in a 58-year-old woman. MR imaging showed a well-circumscribed lesion that was hyperintense on T1-weighted and T2-weighted MR images, and hypointense on fat-suppressed MR images, consistent with fat content. High apparent diffusion coefficient was noticed on diffusion-weighted MR images. Dynamic gadolinium-chelate enhanced MR imaging showed progressive enhancement. Histopathologically, the lesion was predominantly made of mature adipose tissue and contained thin walled vascular channels consistent with angiolipoma. PMID:23849100

Jourjon, Rebecca; Dohan, Anthony; Brouland, Jean-Philippe; Guerrache, Youcef; Fazel, Afchine; Soyer, Philippe

2013-01-01

384

Primary malignant melanoma of the female urethra.  

PubMed

A case of primary urethral malignant melanoma of a 69-year-old Japanese woman is presented. A hemorrhagic tumor measuring 1 cm in diameter was diagnosed by the stamp method. Clinically, the primary lesion was a T4 tumor infiltrating to the bladder neck, vagina, and vulva. Computed tomography did not detect any inguinal lymph node swelling or metastases to other sites. We selected radical extirpation, including cystectomy, ureterostomy, and bilateral inguinal and pelvic lymph node dissection. Although she subsequently underwent immunochemotherapy, consisting of dacarbazine, nimustine, vincristine, and beta-interferon, she died of the cancer 14 months postoperatively. PMID:18158055

Yoshizawa, Tsuyoshi; Kawata, Nozomu; Sato, Katsuhiko; Hirakata, Hitoshi; Igarashi, Takumi; Ichinose, Taketo; Yamaguchi, Kenya; Takahashi, Satoru

2007-12-01

385

Chylous ascites: a sequel of pelvic radiation therapy  

SciTech Connect

Chylous ascites is an unusual condition with many causes. Two cases are presented in which it appeared to be related to whole pelvis irradiation in one patient for carcinoma of the vagina and in another for carcinoma of the vulva. The diagnosis is made by paracentesis and analysis of the fluid. The underlying disease usually requires identification by exploratory laparotomy. Although a malignant process is the most common cause, the only findings in the authors' cases were widespread radiation changes in the intestine. After diagnosis treatment by low-fat diet with medium-chain triglyceride supplements resulted in disappearance of chylous ascites.

Sipes, S.L.; Newton, M.; Lurain, J.R.

1985-12-01

386

Reaction to biological drugs: infliximab for the treatment of toxic epidermal necrolysis subsequently triggering erosive lichen planus.  

PubMed

Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin reaction for which there is currently has no standardized treatment, despite its significant mortality. Biological agents such as tumour necrosis factor (TNF)-? antagonists are emerging as a novel treatment for patients with TEN. We report a 32-year-old woman who developed TEN secondary to sulfasalazine, which was treated with infliximab. The infliximab treatment subsequently triggered erosive lichen planus (LP) involving the mouth and vulva. Clinicians should be aware that TNF-? antagonists can cause LP as a paradoxical complication of treatment. PMID:22548502

Worsnop, F; Wee, J; Natkunarajah, J; Moosa, Y; Marsden, R

2012-12-01

387

Resection and Reconstruction of Maxillary Class IIIc Defect in a Case of Adenoid Cystic Carcinoma: Cost-Sensitive Technique without Microvascular Grafts  

PubMed Central

ACC is a rare malignant tumor that affects most commonly the major and minor salivary glands and rarely the paranasal sinuses, lacrimal gland, larynx, ear, vulva, and so forth. The maxillary sinus when affected is considered having a poor prognosis due to delayed diagnosis and delayed treatment credited to its slow spread, late symptoms, and complex anatomy which hampers surgical resection. The expressions of tumor markers too have a significant role in determining the prognosis. The treatment of choice consists of wide radical resection of the tumor followed by radiotherapy. Rehabilitation options in cases with huge maxillary defects still need further exploration.

Adwani, Dwarkadas; Arora, Rajender Singh; Soni, Ramawatar; Adwani, Nitin

2013-01-01

388

Update in Cancer Chemotherapy: Genitourinary Tract Cancer, Part 3: Cancer of the Prostate  

PubMed Central

An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 3 is a review of treatments for cancer of the prostate. The role of cancer chemotherapeutics as adjuvant therapy and in combination modalities in the treatment of prostatic carcinoma has yet to be determined. No single agent or combination can be considered standard therapy. The role of chemotherapy in prostatic carcinoma needs further definition. Only through randomized trials will better guides to better treatment be established.

Wright, Jane C.

1988-01-01

389

Vulvar squamous cell carcinoma developing in a young black African HIV woman.  

PubMed

Vulvar cancers are uncommon, represented in 90% of cases by squamous cell carcinoma (SCC). The reduction of the frequency and the severity proceed by recognition of precancerous or beginning lesions. They occur most often in the third age in postmenopausal women. The diagnosis is almost difficult and often late and therefore prognosis is severe. Conditions for diagnosis and treatment are difficult in underdeveloped countries due to the inaccessibility of proper equipment in the healthcare system. The authors report a case of SCC diagnosed late in a young human immunodeficiency virus (HIV) women who have been treated with neoadjuvant chemotherapy and radical surgery of the vulva. PMID:24475594

Nguessan, K L P; Mian, D B; Kasse, K; Boni, S

2013-01-01

390

Anatomical study on true hermaphroditism in an Indian pig (Sus scrofa domesticus).  

PubMed

A pig was confirmed to be a true hermaphrodite on the basis of gross and histomorphological studies of the genital organs. The genitalia was consisted of left ovary, oviduct, two coiled uterine horns, body of uterus along with right testis and an epididymis. Vagina and vulva were absent but male urethra with prostate gland was present. Grossly the size of all the genital organs appeared to be normal. Histomorphologically, testis and epididymis were underdeveloped as there was no clearcut spermatogenia and sertoli cells but Leydig cells were normal. The ovary presents normal histological features with some portion of testicular tissue. Degeneration of uterine epithelium was observed along with normal endometrial glands. PMID:15785130

Bansal, Neelam; Roy, K S; Sharma, D K; Sharma, Rajnish

2005-03-01

391

[Selected vulvar dermatoses].  

PubMed

Numerous cutaneous lesions are located in the region of the female genital organs, occasionally presenting a diagnostic and therapeutic challenge. The most common cases include: eczema vulvae, lichen simplex chronius, lichen sclerosus et atrophicus or lichen planus. Clinical presentation of these lesions is not always characteristic for certain dermatoses. Thus, it is important to conduct proper tests, including histopathological or contact allergy examination. Only thorough diagnostics allows to implement correct therapy. This paper shows a detailed description of dermal lesions located in the region of the female genital organs of the allergic and lichenoid origin, together with the literature review on diagnosis and treatment. PMID:24455854

Olek-Hrab, Karolina; Jenerowicz, Dorota; Osmola-Ma?kowska, Agnieszka; Pola?ska, Adriana; Teresiak-Miko?ajczak, Ewa; Silny, Wojciech; Adamski, Zygmunt

2013-11-01

392

Diagnostica per immagini  

Microsoft Academic Search

Il ruolo dell’imaging nel follow-up delle pazienti curate per neoplasia dell’apparato genitale (cervice uterina, endometrio,\\u000a ovaio o vulva) ha come scopo principale, oltre alla valutazione dell’efficacia della terapia stessa, il tempestivo riconoscimento\\u000a dell’insorgenza di un’eventuale recidiva: circa il 30% delle pazienti con neoplasia della portio muore per persistenza o recidiva\\u000a della malattia entro i primi 2 anni dal trattamento; nel

L. Grazioli; C. Stanga; S. Gambarini

393

Aggressive Angiomyxoma with Perineal Herniation  

PubMed Central

Aggressive angiomyxoma is a rare mesenchymal tumor involving the pelvic-perineal region. It occurs during the third and fourth decade of life and is predominantly seen in females. It presents clinically as a soft tissue mass in variable locations such as vulva, perianal region, buttock, or pelvis. Assessment of extent of the tumor by radiological evaluation is crucial for surgical planning; however, biopsy is essential to establish diagnosis. We present the radiological and pathological features seen in a 43-year-old female diagnosed with abdominal angiomyxoma with an unusual extension to the perineum.

Narang, Seema; Kohli, Supreethi; Kumar, Vinod; Chandoke, Raj

2014-01-01

394

An unusual case of vulval papulonecrotic tuberculid.  

PubMed

The tuberculids are a group of rare cutaneous hypersensitivity reactions that occur in response to a distant focus of mycobacterial infection. Typically, Mantoux testing is strongly reactive, and clinical response to antituberculous treatment is rapid. The papulonecrotic subtype is one such clinical variant, consisting of multiple symmetrical papules, often with central necrosis, distributed preferentially over the trunk and limbs. Localized forms are rare, and mainly involve the genitalia in men. We describe a 26-year-old Indian woman with lymphatic and pulmonary tuberculosis (TB) in association with localized papulonecrotic tuberculid of the vulva, which resolved promptly on treating the underlying TB. PMID:21418269

Wong, S; Rizvi, H; Cerio, R; O'Toole, E A

2011-04-01

395

Acquired Vulvar Lymphangioma Circumscriptum  

PubMed Central

Lymphangioma circumscriptum (LC) is a benign dilation of lymph channels localized to the skin and subcutaneous tissues. It is generally localized in mouth mucosa, tongue, proximal regions of arms and legs, groin, axilla, and trunk. Primary vulvar involvement is very rare. Vulvar involvement occurs in various clinical settings. Here, two uncommon cases with giant lymphangioma circumscriptum mimicking genital warts will be presented: a 55-year-old female patient with extensive lymphangiectasic lesions and genital wart-like papular lesions in the vulva secondary to diffuse scrofuloderma scars and a 60-year-old female patient with verruca-like lesions secondary to chronic inflammation.

Ucmak, Derya; Aytekin, Sema; Sula, Bilal; Akkurt, Zeynep Meltem; Turkcu, Gul; Agacayak, Elif

2013-01-01

396

Angiomyxoid tumour in the renal peripelvic tissues with features of aggressive angiomyxoma.  

PubMed Central

A case of angiomyxoid tumour in the renal peripelvic soft tissue of a 45 year old woman is reported. The encapsulated tumour, measuring 12 x 9 x 6 cm, was solid and firm. The cut surface revealed a yellowish-white, gelatinous, and glistening tumour. Histologically, the tumour was composed of loosely textured spindle and stellate cells with prominent blood vessels of variable calibre. The tumour cells stained strongly for vimentin. These findings strongly resemble those associated with aggressive angiomyxoma in the vulva and perineum. Images

Gondo, T; Takahashi, M; Hoshii, Y; Iwata, T; Kashiwagi, T; Ishihara, T

1995-01-01

397

Squamous cell peritonitis associated with hydrometrocolpos in a multimalformed newborn.  

PubMed

We present the case of a 1 day-old newborn with extensive squamous cell peritonitis resulting from vaginal atresia with hydrometrocolpos and squamous cell reflux through the genital system, a combination rarely recognized in the literature. Delivery was preceded by ultrasound diagnosis of oligohydramnios and "large bladder," the latter representing the dilated proximal vagina. Additional findings included paraesophageal hiatus hernia containing squames, urethral atresia, absence of vulva, lung hypoplasia, mild hypoplasia of the corpus callosum, and short umbilical cord with single umbilical artery (SUA). The possible relationship of the SUA with the constellation of infradiaphragmatic malformations is discussed. PMID:16338878

Drut, Ricardo

2005-01-01

398

Vulvar dermatoses: lichen sclerosus, lichen planus, and vulval dermatitis/lichen simplex chronicus.  

PubMed

In our vulvar specialty clinic at Oxford Radcliffe Hospital (Oxford, UK), dermatoses are frequently seen. A recent survey of new patients showed that lichen sclerosus was the most commonly diagnosed vulvar dermatosis; approximately one third of the women had this disorder. Vulvar dermatitis was observed in 20% to 25% of new patients, but lichen planus was rare. Differences were observed in treatment outcomes for patients with vulvar dermatoses, such as lichen sclerosus and lichen planus, versus those with dermatologic disorders affecting the vulva, such as psoriasis and eczema. PMID:9759675

Ball, S B; Wojnarowska, F

1998-09-01

399

Lateral ventricular cystic meningioma: 2 rare case reports  

PubMed Central

Cystic meningioma is an uncommon meningioma variant that is often difficult to distinguish from other intra-axial tumors, including necrotic gliomas. Cystic meningiomas located in the ventricle are particularly rare and may be misdiagnosed with other brain tumors, including ependymoma, choroid plexus papilloma and neurocytoma, due to its location. The present study discusses two cases of lateral ventricular meningiomas, which exhibited intratumoral or peritumoral cystic changes on magnetic resonance imaging scans. The two patients underwent surgical treatment and histological examination confirmed one case of metaplastic meningioma and the other case of psammomatous meningioma. The two patients were middle-aged females and had been misdiagnosed prior to surgery. Although this clinical entity is rare, the diagnosis of meningioma should be considered, particularly in middle-aged female patients.

QIU, LI-HUA; LUI, SU; ZOU, LING; YUE, QIANG; GONG, QI-YONG

2014-01-01

400

Abdominal pregnancy as a cause of hemoperitoneum  

PubMed Central

The coexistence of intrauterine and extrauterine pregnancy, the heterotopic pregnancy, is a rare obstetric phenomenon. The preoperative diagnosis of this condition is very difficult; leading to a higher maternal morbidity and fetal loss. We experienced a case of intrauterine pregnancy and ruptured abdominal pregnancy implanted on the illeocaecal region in a 26-year-old primiparous woman. She was clinically misdiagnosed as a case of ruptured ectopic pregnancy, but ultrasonography showed it to be a case of heterotopic pregnancy. Subsequently, the patient was subjected to laparotomy and the ruptured abdominal pregnancy was evacuated. She continued with the intrauterine pregnancy till term and delivered a healthy female baby. Although this condition is unusual, any general surgeon in the emergency department must be aware of this complication and its management, which is often initially misdiagnosed.

Shafi, Sheikh Muzamil; Malla, Misbha Afsheen; Salaam, Parvaiz Ahmed; Kirmani, Omer Shareef

2009-01-01

401

Cervical Lymph Node Sarcoidosis Mimicking a Parathyroid Adenoma: A Clinical Case  

PubMed Central

We report a case of cervical lymph node sarcoidosis misdiagnosed as parathyroid adenoma. This is the second case described in the literature in which lymph node sarcoidosis was misdiagnosed as parathyroid adenoma on Tc-99m sestamibi (MIBI) scan, the first case localized in the neck. A 64-year-old woman presented with a hypercalcemia. Neck ultrasonography revealed a paratracheal hypoechoic mass of 15 mm with peripheral vascularization. MIBI scan and SPECT/CT identified a MIBI-positive area corresponding to the nodule detected by ultrasonography suggestive for a lower right parathyroid adenoma. A mass interpreted as the lower parathyroid was excised associated to a total thyroidectomy. Pathologic examination revealed a granulomatous lymph node consistent with active sarcoidosis. Sarcoidosis should be suspected as a cause of unexplained hypercalcemia and the differential diagnosis of hypercalcemia, even in presence of MIBI uptake, must include sarcoidosis localized in an isolated cervical lymph node.

Calo, Pietro Giorgio; Pisano, Giuseppe; Tatti, Alberto; Loi, Giulia; Furcas, Silvia; Nicolosi, Angelo

2013-01-01

402

A case of an aortic dissection in a young adult: a refresher of the literature of this "great masquerader"  

PubMed Central

Aortic dissection is often misdiagnosed, especially among young patients, and it is associated with a high mortality rate. We present here a case of fatal acute aortic dissection in a young man who was misdiagnosed with pericarditis. We reviewed the literature of acute aortic dissection in young people and we focused particularly on clinical presentations, outcomes and investigations of aortic dissection. We report a case of a 33-year-old man with a history of uncontrolled hypertension with acute pleuretic chest pain who was transferred to our hospital for suspected pulmonary embolism and died of acute hemorragic pericardial effusion from an ascendant aortic dissection. We should never rule out aortic dissection off our differential diagnosis on the sole basis of a patient’s young age.

Pineault, Jerome; Ouimet, Denis; Pichette, Vincent; Vallee, Michel

2011-01-01

403

Pulmonary intravascular talcosis mimicking miliary tuberculosis in an intravenous drug addict.  

PubMed

Pulmonary foreign body granulomatosis following intravenous administration of medications meant for oral use among drug addicts has been occasionally reported. This condition is often misdiagnosed because of its rarity, but rather due to its similarity to other pulmonary diseases that are more common. Here we report a case of pulmonary intravascular talcosis mimicking miliary tuberculosis in a young male intravenous drug addict from North-Eastern Estonia, known as a hotspot for tuberculosis and drug misuse. The condition was caused by intravenous administration of crushed tablets of diphenhydramine, but miliary tuberculosis was misdiagnosed on patient's demographical, clinical and radiological grounds and a decision to start treatment with four first-line antituberculosis drugs followed. The current report refers to the importance of considering rare causes of pulmonary disseminations with attempts to identify the causative agent and warns against the use of antituberculosis treatment without confirmation of microbiological diagnosis of tuberculosis. PMID:24713715

Altraja, Alan; Jürgenson, Katre; Roosipuu, Retlav; Laisaar, Tanel

2014-01-01

404

Isolated Hepatic Tuberculosis Presenting as Cystic-Like and Tumour-Like Mass Lesions  

PubMed Central

Hepatic tuberculosis is a rare manifestation of extra-pulmonary tuberculosis. Hepatic tuberculous lesions are especially mimicking tumour-like mass or cystic lesions in the liver and so can be misdiagnosed with several diseases. Histopathological examination of the specimen is essential in the diagnosis for hepatic tuberculosis. In this report, two cases with hepatic tuberculosis having cystic solid mass and abscess liver lesions are described.

Parsak, Cem Kaan; Hanta, Ismail; Aslan, Ahmet; Alabaz, Omer

2008-01-01

405

Don't judge a book by its cover: ADHD-like symptoms in obsessive compulsive disorder  

Microsoft Academic Search

Reported OCD-ADHD comorbidity rates are highly variable and the two disorders are characterized by opposite symptomatology and antithetical pathophysiology. We hypothesized that OCD-related attentional impairment could be misdiagnosed as ADHD symptoms. Thirty adults with OCD, thirty with ADHD, and thirty matched healthy controls (HC) completed disorder-specific measures and an ADHD DSM-IV based questionnaire examining childhood and current symptoms. The ADHD

Amitai Abramovitch; Reuven Dar; Andrew Mittelman; Avraham Schweiger

2013-01-01

406

Three-dimensional power Doppler sonography in the diagnosis of a cystic sacrococcygeal teratoma mimicking a meningomyelocele: A case report.  

PubMed

Sacrococcygeal teratomas have been diagnosed prenatally on sonograms as masses of cystic, solid, or mixed echogenicity from the sacral area and protruding through the perineum or buttocks. However, a cystic sacrococcygeal teratoma may be misdiagnosed as an anterior sacral meningomyelocele, especially when presenting as a posterior cystic mass. We report a case in which three-dimensional power Doppler imaging was helpful for making a correct prenatal diagnosis of a type 1 cystic sacrococcygeal teratoma, which mimicked a meningomyelocele. PMID:19484739

Sugitani, Maiko; Morokuma, Seiichi; Hidaka, Nobuhiro; Kinoshita, Yoshiaki; Taguchi, Tomoaki; Tsukimori, Kiyomi; Wake, Norio

2009-09-01

407

Sudden death and laryngeal papillomatosis: a case report.  

PubMed

Laryngeal papillomatosis is an uncommon respiratory disease. Often misdiagnosed, it can cause acute respiratory insufficiency, quickly fatal if not promptly faced. A case of sudden death due to laryngeal papillomatosis is described in a woman presenting to the Emergency Department (ED). Laryngeal obstruction was not diagnosed in previous medical examinations nor recognised at the time of attempted intubation in ED; only post-mortem investigation allowed discovering a large fleshy mass occluding the larynx in the region of the vocal folds. PMID:23622494

Ossoli, Andrea; Verzeletti, Andrea

2013-05-01

408

Dermatoscopy in the diagnosis of tinea nigra.  

PubMed

Tinea nigra is an asymptomatic superficial fungal infection caused by Phaeoannelomyces werneckii, generally affecting the skin of the palms and characterized by deeply pigmented macular non-scaly patches. These lesions are quite characteristic. However, they can be misdiagnosed as a malignant melanoma or a junctional melanocytic nevus and unnecessary biopsies may be performed. Thus, dermoscopy is a fast, useful, clinical adjunctive tool in differentiating tinea nigra from melanocytic lesion. PMID:19061575

Xavier, Marcus Henrique de S B; Ribeiro, Lúcia Helena S; Duarte, Hélio; Saraça, Giani; Souza, Angela Cristina L

2008-01-01

409

Unilocular macrocystic serous cystadenoma of the pancreas--atypical features: a case report.  

PubMed

The authors report and discuss an exceedingly rare case of a unilocular macrocystic serous cystadenomas diagnosed in a 63-year-old female patient, which was preoperatively misdiagnosed as a mucinous cystic neoplasm, due to the atypical magnetic resonance (MR) imaging features shown at presentation and the misleading results obtained through cystic fluid analysis. This manuscript overviews the typical and atypical manifestations of this entity and highlights the advantages, potential limitations and pitfalls of both MR imaging and cystic fluid analysis. PMID:24461471

Leite, Inês; Palmeiro, Marta; Farchione, Alessandra; Matos, Celso; Bali, Maria Antonieta; Demetter, Pieter; Delhaye, Myriam

2014-01-01

410

The Tullio phenomenon: a neurologically neglected presentation  

Microsoft Academic Search

The Tullio phenomenon refers to sound-induced disequilibrium or oscillopsia. Patients with this condition frequently present\\u000a to neurologists, many of whom are unfamiliar with the condition and its diagnostic criteria. Indeed, due to the unusual nature\\u000a of the symptoms patients are often misdiagnosed as having psychiatric disturbances. Tullio patients describe disequilibrium,\\u000a auditory and visual symptoms, which are recurrent, brief, and often

Diego Kaski; R. Davies; L. Luxon; A. M. Bronstein; P. Rudge

411

Autism Spectrum Disorder: A Case of Misdiagnosis  

Microsoft Academic Search

Children who exhibit autistic features, or who are diagnosed with Autism Spectrum Disorder, are not necessarily autistic.\\u000a Some of these misdiagnosed children employ autistic defenses to protect themselves against abuse or neglect, keeping outsiders,\\u000a even those close to them, at a safe distance. This article reviews current research to better understand how etiology and\\u000a individual factors have an impact on

Lori M. Baudino

2010-01-01

412

Treatment of dysautonomia in extrapyramidal disorders  

Microsoft Academic Search

Although extrapyramidal diseases are commonly thought to solely affect the (extrapyramidal) motor system, non-motor symptoms\\u000a such as behavioural abnormalities, dysautonomia, sleep disturbances and sensory dysfunctions are also frequently observed.\\u000a Autonomic dysfunction is an important clinical component of extrapyramidal disease, but it is often not formally assessed,\\u000a and thus frequently misdiagnosed. Symptoms of autonomic dysfunction can impact more on quality of

Tjalf Ziemssen; Gerd Fuchs; Wolfgang Greulich; Heinz Reichmann; Michael Schwarz; Birgit Herting

2011-01-01

413

Susac syndrome in a young child  

Microsoft Academic Search

Susac syndrome is a microangiopathy of unknown origin affecting the brain, retina and inner ear. This rare entity is often\\u000a misdiagnosed as a demyelinating condition such as multiple sclerosis or acute disseminated encephalomyelitis. A high index\\u000a of suspicion must be present as the majority of patients do not have the complete clinical triad at the time of onset of symptoms.

Thomas Jose Eluvathingal Muttikkal; Surjith Vattoth; Venugopal Naik Keluth Chavan

2007-01-01

414

Cervicoisthmic choriocarcinoma mimicking cesarean section scar ectopic pregnancy.  

PubMed

Primary choriocarcinoma of the uterine cervix is an extremely rare disease. The clinical diagnosis of cervical choriocarcinoma is difficult, because of its rarity and being non-specific abnormal vaginal bleeding the most common symptom. In the present report, the authors present a case of cervical choriocarcinoma, which was initially misdiagnosed as a cesarean section scar ectopic pregnancy. Remission of cervical choriocarcinoma was accomplished with the combination of hysterectomy and chemotherapy. PMID:24497867

Sorbi, Flavia; Sisti, Giovanni; Pieralli, Annalisa; Di Tommaso, Mariarosaria; Livi, Lorenzo; Buccoliero, Anna Maria; Fambrini, Massimiliano

2013-10-01

415

Generalized hair casts due to traction.  

PubMed

Peripilar keratin casts, also called pseudonits or hair casts, are thin, elongated, greyish-white, cylindrical, sleeve-like structures that encircle the hair shaft and can easily be slid along the hair. They may be clinically misdiagnosed as nits. In addition to physical removal, keratolytic lotions or shampoos are helpful. We report an 11-year-old girl with pseudonits. Although it is not a rare condition, underdiagnosis is common. PMID:23909653

Ozuguz, Pinar; Kacar, Seval; Takci, Zennure; Ekiz, Ozlem; Kalkan, Goknur; Bulbul Sen, Bilge

2013-01-01

416

Disseminated paracoccidioidomycosis diagnosis based on oral lesions  

PubMed Central

Paracoccidioidomycosis (PCM) is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

Webber, Liana Preto; Martins, Manoela Domingues; de Oliveira, Marcia Gaiger; Munhoz, Etiene Andrade; Carrard, Vinicius Coelho

2014-01-01

417

Acute appendicitis presenting as acute diarrhea accompanying hypokalemia.  

PubMed

Acute appendicitis, characterized as periumbilical pain, migrating to the right iliac fossa, is one of the most common acute surgical conditions. It is usually diagnosed on the basis of clinical signs and symptoms. However, some patients may present atypically and are prone to be misdiagnosed. We report this first case of acute appendicitis who presented initially with complain of diarrhea accompanying hypokalemia. There have been no published data suggesting its existence in any parts of the world. PMID:24332249

Wang, Li Jun; Basnet, Samjhana; Du, Xiao Qin; Shou, Song Tao

2014-04-01

418

Crowned Dens Syndrome: A Case Report and Review of the Literature  

PubMed Central

The crowned dens syndrome (CDS), also known as periodontoid calcium pyrophosphate dehydrate crystal deposition disease, is typified clinically by severe cervical pain, neck stiffness and atlantoaxial synovial calcification which could be misdiagnosed as meningitis, epidural abscess, polymyalgia rheumatica, giant cell arthritis, rheumatoid arthritis, cervical spondylitis or metastatic spinal tumor. Crystalline deposition on cervical vertebrae is less well known disease entity and only a limited number of cases have been reported to date. Authors report a case of CDS and describe the clinical feature.

Lee, Gwang Soo; Park, Hyung Ki; Chang, Jae Chil

2014-01-01

419

Imaging features of posterior limbus vertebrae.  

PubMed

Posterior limbus vertebra (PLV) is the retropulsion of the vertebral ring apophysis resulting from disc herniation through posterior ring physis. Large PLV can cause spinal stenosis, and small PLV can be mistaken as intraspinal disc herniation. Although the clinical presentations were similar, the surgery was quite different. We had experienced preoperative misdiagnosed cases and the surgery could not be finished. Therefore we analyzed the imaging features of PLV in 34 patients in order to prompt appropriate preoperative diagnosis and surgical planning. PMID:23154012

Huang, Pei-Yu; Yeh, Lee-Ren; Tzeng, Wen-Sheng; Tsai, Meng-Yuan; Shih, Tiffany Ting-Fang; Pan, Huay-Ben; Chen, Clement Kuen-Huang

2012-01-01

420

Posterior fossa subdural hematoma mimicking intracerebellar hemorrhage.  

PubMed

Subdural hematomas of the posterior fossa are very rare and most cases are related to head injury. The influence of anticoagulation in cases of spontaneous development is well known. Although diagnosis is easily achieved by CT sean, atypical forms may lead to the wrong diagnosis of cerebellar hematoma. We present a case of a posterior fossa acute subdural hematoma occurring in an anticoagulated patient who was preoperatively misdiagnosed as an intracerebellar hemorrhage. PMID:14710308

Miranda, P; Alday, R; Lagares, A; Pérez, A; Lobato, R D

2003-12-01

421

Challenging diagnosis between intussusception and necrotizing enterocolitis in premature infants.  

PubMed

Although necrotizing enterocolitis (NEC) is a frequently encountered entity in premature infants in the neonatal intensive care unit, intussusception is extremely rare. Abdominal distension, bilious/non-bilious gastric residuals and bloody stool are the common clinical findings of both entities. Here we present three cases of intussusception misdiagnosed as NEC, two of which were complicated with intestinal perforation. Similar clinical findings of NEC and intussusception leads to misdiagnosis and delay in treatment, particularly in premature infants with intussusception. PMID:24894937

Ta?k?nlar, Hakan; Gündo?du, Gökhan; Celik, Yalç?n; Avlan, Dinçer; Nayc?, Ali

2014-06-01

422

Calcium hydroxyapatite deposition disease in the hand and wrist: a report of six cases  

Microsoft Academic Search

Calcium hydroxyapatite deposition [CHAD] of the hand and wrist, known also as acute calcific tendonitis, is an uncommon entity\\u000a frequently misdiagnosed as infection, tumor or a tumor-like condition. We describe a series of seven patients in whom the\\u000a clinical features, means of diagnosis, pathophysiology and modalities of conservative and surgical treatment are discussed.\\u000a The proper diagnosis avoids unnecessary antibiotic treatment,

S. Stahl; T. Kaufman; D. Schapira

1998-01-01

423

Primary thymic carcinoid with Cushing's syndrome  

Microsoft Academic Search

Summary  In a 52-year-old Caucasian man osteopoikilosis had been misdiagnosed roentgenologically 2 years before his death. Gradually\\u000a he developed Cushing's syndrome and ultimately superior vena caval obstruction. At autopsy a primary thymic carcinoid with\\u000a extensive osteoblastic bone metastasis was found. Immunohistochemically the tumor was shown to be positive for adrenocorticotropic\\u000a hormone (ACTH), cytokeratin (KL1), neuron-specific enolase, synaptophysin, chromogranin and glucagon. Remarkably

Gregor Wollensak; Eberhard Walter Herbst; Andreas Beck; Hans-Eckart Schaefer

1992-01-01

424

Erythema infectiosum: an epidemic that mimics rubeola.  

PubMed

Erythema infectiosum occurs mainly in epidemics among school children and is often misdiagnosed as rubella, rubeola, or another exanthem. This may cause unnecessary treatment and prolonged absence from school. Etiology is presumably viral, and mode of transmission presumably droplet nuclei, but neither of these factors are proven. Diagnosis at present is based on clinical information only. This paper reports the investigation of 80 cases within a school, through the cooperation of community physicians and health unit personnel. PMID:20469391

Galvon, F A

1982-12-01

425

Anterior clinoid mucocele--clinical presentation, investigations, and management by endoscopic excision: review of literature.  

PubMed

Mucoceles in the anterior clinoid location are exceptionally rare. They present with visual failure and are often misdiagnosed as unilateral optic neuritis. Early recognition with imaging studies and prompt surgical excision is the treatment of choice. Endoscopic surgery achieves this with the least surgical trauma and hospitalization. We report two cases of anterior clinoid mucocele that were treated successfully by endoscopic surgery and also review its management. PMID:23512586

Kuruvath, Sarin; Ahmed, Shahzada; Johnson, Alan; Shad, Amjad

2013-12-01

426

Importance of Video-EEG Monitoring in the Diagnosis of Refractory Panic Attacks.  

PubMed

Partial seizures can be misdiagnosed as panic attacks. There is considerable overlap of symptoms between temporal lobe seizures and panic attacks making the diagnosis extremely challenging. Temporal lobe seizures can present with intense fear and autonomic symptoms which are also seen in panic disorders. This results in delay in diagnosis and management. We report an interesting case of a young woman who was diagnosed with right temporal lobe seizures with symptoms suggestive of a panic attack. PMID:23984151

Kirmani, Batool F; Mungall, Diana

2013-01-01

427

Importance of Video-EEG Monitoring in the Diagnosis of Refractory Panic Attacks  

PubMed Central

Partial seizures can be misdiagnosed as panic attacks. There is considerable overlap of symptoms between temporal lobe seizures and panic attacks making the diagnosis extremely challenging. Temporal lobe seizures can present with intense fear and autonomic symptoms which are also seen in panic disorders. This results in delay in diagnosis and management. We report an interesting case of a young woman who was diagnosed with right temporal lobe seizures with symptoms suggestive of a panic attack.

Kirmani, Batool F.; Mungall, Diana

2013-01-01

428

Frozen shoulder - A stiff problem that requires a flexible approach.  

PubMed

Frozen shoulder is a specific, painful and debilitating condition effecting patients mainly in middle age. While it has been recognised for over 100 years, it is still mis-diagnosed, with a natural history that is poorly understood and with limited evidence for the efficacy for various treatments. This review considers what is known about this common painful condition and the treatments available. PMID:24636964

Guyver, P M; Bruce, D J; Rees, J L

2014-05-01

429

Lymphomatosis Cerebri  

PubMed Central

Lymphomatosis cerebri is considered a diffuse form of primary central nervous system lymphoma and very rare. It is not well recognized and may be misdiagnosed with infiltrating tumors, degenerative disorders, ischemic diseases, and infectious diseases developed in the brain. Awareness of the possibility of this rare disease and early biopsy are required for differential diagnosis and preventing poor clinical outcomes. We report a case with lymphomatosis cerebri who presented with rapid neurological deteriorations and review the relevant literatures.

Lee, Chae-Heuck; Joo, Mee

2013-01-01

430

Seeing the invisible: painless aortic dissection in the emergency setting.  

PubMed

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department. PMID:16498148

Ayrik, C; Cece, H; Aslan, O; Karcioglu, O; Yilmaz, E

2006-03-01

431

Seeing the invisible: painless aortic dissection in the emergency setting  

PubMed Central

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department.

Ayrik, C; Cece, H; Aslan, O; Karcioglu, O; Yilmaz, E

2006-01-01

432

Osteosarcoma invasion of the inferior vena cava and right atrium.  

PubMed

We present a woman with chondroblastic osteosarcoma of the left ilium extending to the L4 epidural space and invading the inferior vena cava and right atrium, misdiagnosed as deep venous thrombosis. After neoadjuvant chemotherapy, two stage resection was planned. During the anterior approach, a mass in the left common iliac vein and inferior vena cava was found and tumor thromboembolism was diagnosed. Frozen sections showed chondroblastic osteosarcoma. The patient denied further surgery and had palliative intensity modulated radiation therapy. PMID:22995361

Mavrogenis, Andreas F; Angelini, Andrea; Sakellariou, Vasileios I; Skarpidi, Evangelia; Ruggieri, Pietro; Papagelopoulos, Panayiotis J

2012-01-01

433

Flail subaortic membrane mimicking left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.  

PubMed

A subaortic membrane is an uncommon cause for left ventricular outflow tract obstruction. Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction would mask the presence of the subaortic membrane on transthoracic echocardiography and cause a false diagnosis. We report a patient with subaortic stenosis due to flail subaortic membrane misdiagnosed as obstructive hypertrophic cardiomyopathy on transthoracic echocardiography, identified on transesophageal echocardiography and cardiac catheterization. PMID:23837119

Ahn, Kye Taek; Lee, Young Dal; Choi, Ung-Lim; Jin, Seon-Ah; Park, Soo-Jin; Kim, Jun-Hyeong; Park, Jae-Hyeong; Lee, Jae-Hwan; Choi, Si Wan; Jeong, Jin-Ok

2013-06-01

434

Mixed paratesticular liposarcoma with osteosarcoma elements  

Microsoft Academic Search

Spermatic cord sarcomas (SCS) are very infrequent and sometimes misdiagnosed malignancies. Moreover, their optimal management\\u000a remains undefined with ongoing controversy about the indications for adjuvant therapy. Histologically, liposarcomas are the\\u000a most common type. Osteosarcoma is rarely observed in this location and combined tumours with this component have not been\\u000a described. We present a case of SCS with mixed differentiation with

Lisardo Ugidos; Ana Suárez; Antonio Cubillo; Ignacio Durán

2010-01-01

435

Enduring Fluoride Health Hazard for the Vesuvius Area Population: The Case of AD 79 Herculaneum  

Microsoft Academic Search

BackgroundThe study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological lesions. Even today its early stages are misdiagnosed in endemic areas.Methodology\\/Principal

Pierpaolo Petrone; Michele Giordano; Stefano Giustino; Fabio M. Guarino

2011-01-01

436

Neuromyelitis optica  

Microsoft Academic Search

Opinion statement  Neuromyelitis optica (Devic’s syndrome) is an uncommon, idiopathic, demyelinating syndrome of the central nervous system that\\u000a preferentially affects the optic nerves and spinal cord. It frequently is misdiagnosed as severe multiple sclerosis, but usually\\u000a is readily distinguished from multiple sclerosis in fully developed cases because of its severity, typical magnetic resonance\\u000a imaging (MRI) findings (normal brain MRI; longitudinally extensive

Dean M. Wingerchuk; Brian G. Weinshenker

2005-01-01

437

Depression, quality of life and breast cancer: a review of the literature  

Microsoft Academic Search

Depression is misdiagnosed and undertreated among breast cancer population. Risk factors for depression in the 5 years after\\u000a diagnosis are related more to the patient rather than to the disease or its treatment. The breast cancer stage (early and\\u000a advanced) is not statistically significant in terms of rates of psychosocial distress except for recurrence. Risk factors\\u000a of depression might impair quality

M. Reich; A. Lesur; C. Perdrizet-Chevallier

2008-01-01

438

Thyrotoxic psychosis in an elderly woman and haloperidol use: a case report.  

PubMed

Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61-year-old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state. PMID:23551412

Emul, Murat; Sakalli, Ayse; Erol, Turgut Can; Ertan, Turan

2013-03-01

439

Pseudomonas folliculitis.  

PubMed

Pseudomonas folliculitis has been reported by several authors in recent literature. So far, most of the outbreaks involved whirlpools in motels, health spas and private homes. This communication may be the first report of whirlpool folliculitis occurring in an apartment complex. This new clinical entity, which may be misdiagnosed as other pruritic dermatoses, can spread to involve many individuals with significant epidemiologic implications. PMID:21286148

Jen, I

1982-08-01

440

Melanocytic nevi simulant of melanoma with medicolegal relevance  

Microsoft Academic Search

A group of melanocytic benign nevi are prone to be misdiagnosed as nodular or superficial spreading melanoma. This review\\u000a illustrates the most frequent forms of these nevi in direct comparison with their malignant morphologic counterparts. The\\u000a nevi are: hyper-cellular form of common nevus to be distinguished from nevoid melanoma, Spitz nevus (vs spitzoid melanoma),\\u000a Reed nevus (vs melanoma with features

Guido Massi

2007-01-01

441

The Clinical and Molecular Heterogeneity of 17?HSD-3 Enzyme Deficiency  

Microsoft Academic Search

17-?-hydroxysteroid dehydrogenase type 3 (17?HSD-3) deficiency is a rare, but frequently misdiagnosed autosomal recessive cause of 46,XY disorder of sex development (DSD). 17?HSD-3 enzyme is present almost exclusively in the testes and converts ?4-androstenedione (?4) to testosterone (T). The diagnosis can be easily missed in early childhood as the clinical presentation may be subtle. Any young girl with an inguinal

Minu M. George; Maria I. New; Svetlana Ten; Charles Sultan; Amrit Bhangoo

2010-01-01

442

Cervical thymic cyst: a case report.  

PubMed

Cervical thymic cysts are rare lesions often misdiagnosed clinically as branchial cyst. Here we report a rare case of multiloculated thymic cyst in a young 8 year old male child on the left side of the neck. Histopathology of the excised cyst revealed mural nodules of thymic tissue with prominent Hassal's corpuscles associated with multiloculated cyst. This case is presented here for its rarity. It should be included in the differential diagnosis of neck masses in children. PMID:24427638

Prabhakar, Gundala; Santhosh, A N; Manjunath, S S; Santosh, K V

2013-07-01

443

Refractory Thrombocytopenia, an Unusual Myelodysplastic Syndrome with an Initial Presentation Mimicking Idiopathic Thrombocytopenic Purpura  

Microsoft Academic Search

Refractory thrombocytopenia (RTC) is an unusual subtype of myelodysplastic syndrome (MDS) that initially presents as chronic\\u000a pure thrombocytopenia. Because of the lack of distinguishable dysplasia, RTC has often been misdiagnosed as idiopathic thrombocytopenic\\u000a purpura.We describe the case of a patient with RTC and trisomy 8 for whom a bone marrow mononuclear cell (BMNC) gene expression\\u000a profile was obtained by means

Jun Qian; Yongquan Xue; Jinlan Pan; Jiannong Cen; Wei Wang; Zixing Chen

2005-01-01

444

HLA-DR antibodies in transfusion-related acute lung injury (TRALI): A case report  

Microsoft Academic Search

Transfusion-related acute lung injury (TRALI) is a serious adverse consequence of blood product transfusion. Cases of TRALI have gone unrecognized or misdiagnosed, since the symptoms can be confused with other transfusion-related events or with non-transfusion related comorbidities. Suspected cases of TRALI may be insufficiently investigated, and mild or moderate cases may not be investigated or reported at all. We report

Manuel Muro; Jose Rivera; Carmen Botella; Jose A. Campillo; Francisca Ferrer; María R. Álvarez-López

2008-01-01

445

Two novel deletions in hypotonia-cystinuria syndrome.  

PubMed

Hypotonia-cystinuria syndrome (HCS) is an autosomal recessive disorder caused by combined deletions of SLC3A1 and PREPL. Clinical features include cystinuria, neonatal hypotonia with spontaneous improvement, poor feeding in neonates, hyperphagia in childhood, growth hormone deficiency, and variable cognitive problems. Only 14 families with 6 different deletions have been reported. Patients are often initially misdiagnosed, while correct diagnosis enables therapeutic interventions. We report two novel deletions, further characterizing the clinical and molecular genetics spectrum of HCS. PMID:22796000

Régal, Luc; Aydin, Halil Ibrahim; Dieltjens, Anne-Marie; Van Esch, Hilde; Francois, Inge; Okur, Ilyas; Zeybek, Cengiz; Meulemans, Sandra; Van Mol, Christine; Van Bruwaene, Lore; Then, Siao-Hann; Jaeken, Jaak; Creemers, John

2012-11-01

446

A large proportion of prediabetes and diabetes goes undiagnosed when only fasting plasma glucose and\\/or HbA 1c are measured in overweight or obese patients  

Microsoft Academic Search

AimsThe purposes of the study were to determine the prevalence of unrecognized dysglycaemia in overweight (body mass index [BMI] 25–29.9kg\\/m2) and obese (BMI ?30kg\\/m2) patients, to assess the extent to which measures of fasting plasma glucose (FPG) and\\/or HbA1c, compared with oral glucose tolerance tests (OGTTs), misdiagnose dysglycaemia, and to determine the factors associated with an isolated abnormal post-OGTT glucose

E. Cosson; E. Hamo-Tchatchouang; I. Banu; M.-T. Nguyen; S. Chiheb; H. Ba; P. Valensi

2010-01-01

447

Pseudogout in the early postoperative period after total knee arthroplasty.  

PubMed

Postoperative pseudogout after total knee arthroplasty is rare. If pseudogout attacks are misdiagnosed as periprosthetic sepsis, patients may undergo unnecessary surgical procedures. We report a case of pseudogout in the early postoperative period. The attack ensued shortly after a nonsteroidal antiinflammatory drug was discontinued. The diagnosis was confirmed by aspiration, and the patient improved after readministration of the nonsteroidal antiinflammatory drug. Although rare, pseudogout should be considered in the differential when approaching a suspected infection after total knee arthroplasty. PMID:22522109

Harato, Kengo; Yoshida, Hiroki

2013-02-01

448

[Acute airway obstruction mimicking angioedema and revealing spontaneous compressive haematoma of thyroid goitre].  

PubMed

Substernal thyroid goitre is the most common cause of superior mediastinal masses. Respiratory symptoms are commonly present, in up to 90% of reported cases. However, these symptoms are rarely acute and life threatening. We report a case of acute airway obstruction, initially misdiagnosed as angioedema, revealing a spontaneous compressive substernal goitre haematoma, in a patient under anticoagulant. This life-threatening complication in patients with goitre and anticoagulant should be known. PMID:20554089

Loustau, V; Trad, S; Hausfater, P; Touitou, D; Tresallet, C; Boutin, D

2010-12-01

449

Intraosseous hemangioblastoma mimicking spinal metastasis in the patient with renal cell carcinoma.  

PubMed

Sporadic osseous hemangioblastomas in the vertebra are extremely rare and they can be misdiagnosed as a vertebral hemangioma or metastasis in imaging studies. We report an intraosseous hemangioblastoma that arose from the 11th thoracic vertebra and was diagnosed initially as a metastasis in a patient with renal cell carcinoma. Diagnosis, surgical treatment and adjuvant radiosurgery of such case in reference to the literature are discussed. PMID:21887401

Cho, Heecheol; Lee, Sun-Ho; Kim, Eun-Sang; Eoh, Whan

2011-06-01

450

Fishbone-Associated Actinomycosis of the Anterior Cervical Space: A Diagnostic Dilemma  

PubMed Central

We report the imaging and pathologic findings of fishbone-associated actinomycosis of the anterior cervical space in a 57-year-old man, misdiagnosed preoperatively as a malignancy originating from thyroglossal duct cyst. CT revealed an enhancing mass containing a small abscess pocket and two sharp linear calcifications within it, which infiltrated into the strap muscle. Pathologic examination demonstrated two fishbones within the actinomycotic abscess. Fishbone-associated actinomycosis should be considered when a cervical mass contains sharp linear calcifications.

Lee, Sang Kwon; Kim, Mi Jeong; Kwon, Sun Young

2010-01-01

451

A young man with a dizzy spell and acute abdominal pain.  

PubMed

Isolated adrenocorticotropic hormone (ACTH) deficiency is a rare cause of secondary adrenal insufficiency and its presentation with adrenal crisis is rather rare. Acute adrenal insufficiency (adrenal crisis) can be an elusive diagnosis, particularly in previously undiagnosed patients. As in this patient, the presentation of adrenal crisis with acute abdominal pain was misdiagnosed as an acute surgical abdomen, leading to a delay in the diagnosis and in the initiation of life saving treatment. PMID:24115716

Elasha, Hassan Mohamed Saeed; Anjum, Farees; Almalki, Mussa H

2013-10-01

452

[Charles Bonnet syndrome: visual hallucinations in patients with ocular diseases--case report].  

PubMed

In this article the authors report two cases of Charles Bonnet syndrome, defined as complex visual hallucinations in patients with low vision, and the patient is aware of the unreal nature of the phenomenon. A great number of cases is misdiagnosed due to lack of direct questioning by the physician. Since the emotional distress caused by this disease, the knowledge of its symptoms is essential in the management of these patients. PMID:15824818

Cortizo, Vitor; Rosa, Alexandre Antonio Marques; Soriano, Danilo Sone; Takada, Leonel Tadao; Nitrini, Ricardo

2005-01-01

453

Kikuchi-Fujimoto disease masquerading as tuberculosis.  

PubMed

Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting subacute necrotizing lymphadenitis with unknown aetiology that has a predilection for young Far East Asian women. It presents with fever, fatigue and lymphadenomegaly and is often misdiagnosed. We report an unusual presentation in a South Asian woman with isolated mediastinal lymphadenopathy masquerading as tuberculosis. There is only one other reported case in the literature presenting with isolated mediastinal lymphadenopathy. PMID:23456985

Gupta, Prity; Lau, Kelvin; West, Kevin; Rathinam, Sridhar

2014-02-01

454

Managing a Live Advanced Abdominal Twin Pregnancy  

PubMed Central

Advanced abdominal pregnancies with live twin fetuses are extremely rare and are misdiagnosed in up to 60% of the cases. Such a case is presented here, highlighting the diagnostic and management challenges encountered. A high index of suspicion in making the diagnosis of this rare variety of ectopic pregnancy, emphasizing adherence to basic imaging principles, and appropriate placental management is very important in reducing the associated morbidity and mortality.

Mpogoro, FJ; Gumodoka, B; Kihunrwa, A; Massinde, AN

2013-01-01

455

Managing the Unexpected: Complexity as Distributed Sensemaking  

NASA Astrophysics Data System (ADS)

In 1998 the Centers for Disease Control (CDC) published a statement of their strategy entitled "Preventing Emerging Infectious Diseases: A Strategy for the 21st Century." They described their central challenge this way: "because we do not know what new diseases will arise, we must always be prepared for the unexpected" (p. vii). Soon after they published that statement CDC was confronted with an unexpected emerging disease, the West Nile Virus, which they misdiagnosed initially.

Weick, Karl E.

456

Psoas abscess in an immunocompetent host.  

PubMed

We present a case of iliopsoas abscess in an immunocompetent patient. She experienced three weeks of worsening right hip pain, which was initially misdiagnosed as degenerative joint disease. This led to admission to the Intensive Care Unit for severe sepsis. The patient improved with intravenous antibiotics and percutaneous abscess drainage. [Full text available at http://rimed.org/rimedicaljournal-2014-08.asp, free with no login]. PMID:25083956

Mannino, Courtney M; Salhab, Mohammed; Schmidhofer, Sarah; Pop-Vicas, Aurora

2014-01-01

457

Evaluation and Management of Posterior Shoulder Instability  

PubMed Central

Context: Posterior shoulder instability is a commonly misdiagnosed disorder in many competitive athletes. Type of Study: Clinical review. Evidence Acquisition: Relevant studies on posterior shoulder instability from 1950 to 2010 in PubMed and Cochrane databases were reviewed. Results: A total of 107 studies were reviewed. Conclusion: Patients who have undergone at least 6 months of physical therapy and still experience instability symptoms should be considered for surgical stabilization directed at their underlying pathology.

Tannenbaum, Eric; Sekiya, Jon K.

2011-01-01

458

Idiopathic ventral spinal cord herniation: a rare presentation of tethered cord.  

PubMed

Idiopathic ventral spinal cord herniation is a rare condition that has been increasingly reported in the last decade. The natural history and optimal management have yet to be defined. Therefore, debate exists regarding the pathogenesis and surgical management of this condition. The purpose of this review article is to further educate neurosurgeons about the surgical techniques and outcomes associated with treating this rare and often misdiagnosed condition. PMID:20593998

Shin, John H; Krishnaney, Ajit A

2010-07-01

459

Uhl's anomaly in a domestic shorthair cat.  

PubMed

A 2-year-old, neutered male, domestic shorthair cat was presented for investigation of dyspnea and episodic weakness. Clinical and ultrasonographic features were consistent with right ventricular cardiomyopathy. Pathological findings documented Uhl's anomaly. Although rare, Uhl's anomaly should be a differential diagnosis for cats with right-sided congestive heart failure. In particular, Uhl's anomaly could be misdiagnosed as arrhythmogenic right ventricular cardiomyopathy due to the similarity of clinical and echocardiographic findings. PMID:21041339

Quintavalla, Cecilia; Bossolini, Elena; Rubini, Giuseppe; Tursi, Massimiliano

2010-01-01

460

Body dysmorphic disorder: Delusions of physical appearance  

Microsoft Academic Search

Body dysmorphic disorder (BDD) is described as a preoccupation with imagined or slight defects in one’s appearance (eg, acne\\u000a or scarring, the size or shape of the nose). Although BDD was first described more than 100 years ago, only recently has BDD\\u000a been studied empirically. Therefore, BDD is often under- or misdiagnosed. Moreover, individuals with BDD often do not seek

Ulrike Buhlmann; Hannah Reese; Elana Golan; Sabine Wilhelm

2006-01-01

461

Lateral sided snapping elbow caused by a meniscus: two case reports and literature review  

Microsoft Academic Search

Lateral sided snapping elbow is an unusual condition, and it is apt to be misdiagnosed as lateral epicondylitis. The causes\\u000a of lateral sided snapping elbow have been attributed to intraarticular loose bodies, instability, synovial plicae and torn\\u000a annular ligament. We report our experiences for treating lateral sided snapping elbow caused by a meniscus in the radio-humeral\\u000a joint. In the present

Shin-Taek KangTae-Ho Kim; Tae-Ho Kim

2010-01-01

462

La sindrome del piriforme  

Microsoft Academic Search

\\u000a Abstract  Piriformis syndrome (PS) is a frequently misdiagnosed but not so rare neuromuscular disorder that involves buttock pain referred\\u000a to the leg. Piriformis syndrome occurs when the piriformis muscle or a local pathological process compresses or irritates\\u000a the sciatic nerve. Diagnosis is often difficult, and it is of exclusion, due to few validated and standardized diagnostic\\u000a tests. Treatment for PS has

F. Biggi; S. Di Fabio; C. Marchini

2011-01-01

463

Cor triatriatum with a left upper anomalous pulmonary venous return to the innominate vein.  

PubMed

Cor triatriatum sinister is an uncommon congenital cardiac anomaly accounting for 0.1% of all congenital cardiac malformations, with an anomalous venous return being a frequently associated condition. We present the case of a 14-year-old girl misdiagnosed as having an atrial septal defect with pulmonary hypertension who actually had a cor triatriatum with a left upper anomalous pulmonary venous return to the innominate vein. PMID:23829896

Galoin-Bertail, Claire; Gouton, Marielle

2014-06-01

464

Regression of inflammatory pseudotumor of the liver under conservative therapy.  

PubMed

Inflammatory pseudotumors (IPT) of the liver are rare benign tumors of unknown origin. Most previously reported cases were initially misdiagnosed and treated surgically; thus, their course under medical treatment remains unclear. We report an additional case of hepatic IPT with a favorable outcome under medical treatment without surgical resection. New imaging and pathologic features of this disease are presented that may facilitate preoperative recognition and appropriate treatment. PMID:7720466

Jaïs, P; Berger, J F; Vissuzaine, C; Paramelle, O; Clays-Schouman, E; Potet, F; Mignon, M

1995-04-01

465

Cutaneous Lymphadenoma: A Rare Case and Brief Review of a Diagnostic Pitfall  

PubMed Central

We report a case of cutaneous lymphadenoma on the posterior left ear of a 67-year-old woman. Although it is benign, recognition of cutaneous lymphadenoma is important as it presents a diagnostic pitfall to the unsuspecting dermatologist and general surgical pathologist, who may readily misdiagnose the lesion because it is not only very rare, but also clinically and histologically resembles the far more common and locally destructive basal cell carcinoma.

Yu, Ryan; Salama, Samih; Alowami, Salem

2014-01-01

466

Maxillary sinus nodular fasciitis.  

PubMed

Nodular fasciitis is a rare and benign inflammatory condition; however, it can be misdiagnosed as a malignant lesion. We report a unique case of nodular fasciitis arising from the maxillary sinus in a 2-year-old child. Our English literature review (PubMed search), revealed a total of 3 cases published as nodular fasciitis in the para-nasal sinuses, each with a different management approach. PMID:24445897

Alsaied, Abdulmalik S; Lotfy, Mohammed A

2014-01-01

467

Echinococcus granulosus cattle strain identification in an autochthonous case of cystic echinococcosis in central Mexico  

Microsoft Academic Search

Echinococcosis is a frequent hepatic parasitic disease in several countries but it is practically absent in Mexico. A cattle strain of Echinococcus granulosus was identified by RAPD, PCR-RFLP and mitochondrial CO1 gene analysis in an autochthonous case. The parasite was obtained after a laparoscopic excision of a liver cyst from a patient that was symptomatic for 6 years but mis-diagnosed

Pablo Maravilla; R. C. Andrew Thompson; Jose Antonio Palacios-Ruiz; Annika Estcourt; Eduardo Ramirez-Solis; Carmen Mondragon-de-la-Peña; Marcial Moreno-Moller; Alexander Cardenas-Mejia; Pilar Mata-Miranda; Maria-Teresa Aguirre-Alcantara; Carlos Bonilla-Rodriguez; Ana Flisser

2004-01-01

468

Laryngeal myxoma: a case report and review of the literature.  

PubMed

Myxomas are a rare benign neoplasm of uncertain mesenchymal cell origin, typically involving the heart. Laryngeal myxomas are uncommon, and are usually misdiagnosed as laryngeal polyp. To the best of our knowledge, there are only nine reported cases in the English literature. We report a case of a laryngeal myxoma presenting clinically as a left vocal cord polyp in a 77 year old male, and review the literature related to this rare entity. PMID:23975415

Ritchie, Angela; Youngerman, Jay; Fantasia, John E; Kahn, Leonard B; Cocker, Rubina S

2014-06-01

469

Flail Subaortic Membrane Mimicking Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy  

PubMed Central

A subaortic membrane is an uncommon cause for left ventricular outflow tract obstruction. Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction would mask the presence of the subaortic membrane on transthoracic echocardiography and cause a false diagnosis. We report a patient with subaortic stenosis due to flail subaortic membrane misdiagnosed as obstructive hypertrophic cardiomyopathy on transthoracic echocardiography, identified on transesophageal echocardiography and cardiac catheterization.

Ahn, Kye Taek; Lee, Young Dal; Choi, Ung-Lim; Jin, Seon-Ah; Park, Soo-Jin; Kim, Jun-Hyeong; Park, Jae-Hyeong; Lee, Jae-Hwan; Choi, Si Wan

2013-01-01

470

Delivery induced intraperitoneal rupture of a cystic ovarian teratoma and associated chronic chemical peritonitis.  

PubMed

Intraperitoneal rupture of cystic ovarian teratoma is a rare complication. We report a case in a 29-year-old female, with increased abdominal circumference 2 months after vaginal delivery. MRI/CT raised this diagnosis associated to chemical peritonitis. A malignant ovarian mass with peritoneal carcinomatosis was excluded. Laparoscopic oophorectomy was performed and histologic analysis confirmed imaging findings. This case demonstrates the interest of imaging before surgery in pelvic masses to avoid misdiagnosing and to provide adequate treatment. PMID:24744942

Nader, Reine; Thubert, Thibault; Deffieux, Xavier; de Laveaucoupet, Jocelyne; Ssi-Yan-Kai, Guillaume

2014-01-01

471

Anderson-Fabry Disease  

Microsoft Academic Search

Anderson-Fabry disease is a multisystemic lysosomal storage disorder due to a deficiency of ?-galactosidase A resulting in\\u000a an accumulation of neutral glycosphingolipids. Due to its rare occurrence the disease is often misdiagnosed or the correct\\u000a diagnose is delayed for many years (Weidemann et al. 2008). Dermatologists except ophthalmologists play the most important role for early diagnosis of this disorder, which

Anna-Christine Hauser

472

[Tooth mobility disclosing an osteolytic process].  

PubMed

Excepting cases of trauma, dental mobility is often mistakenly neglected as a clinical sign. Dental mobility can in fact be the first sign of osteolytic processes or tumour development. A retrospective study noted that dental mobility may be the inaugural sign of osteolytic processes in the maxillary bone in up to as many as 40% of the cases. Pyorrhea+ is often misdiagnosed leading to unnecessary avulsion and delaying diagnosis of the osteolytic disease. PMID:8650496

Gharbi-Guesguez, L; Abassi-Bakir, D; Bakir, A

1995-01-01

473

Unicystic Ameloblastoma Masquerading as Huge Periapical Lesion, both Clinically and Histopathologically: Two Case Reports with Review of Literature  

PubMed Central

Unicystic ameloblastoma (UA) is one of the variants of ameloblastoma. It manifests as unilocular radiolucency in the mandible or maxilla on X-ray scans. In very rare cases, it can appear as a localized periradicular radiolucent area, imitating a periapical lesion. In this article, we present two cases of UA that were initially misdiagnosed as periapical lesions. Subsequently, surgical enucleation was performed and the diagnosis of UA was confirmed histopathologically.

Satyabhusan, N. V. V.; Routray, Samapika; Bendi, Lavanya; Suresh, B Venkat; Majumdar, Sumit; Mohanty, Neeta

2013-01-01

474

Case of mistaken identity: bullous congenital ichthyosiform erythroderma mistaken as epidermolysis bullosa simplex.  

PubMed

Distinguishing clinically similar dermatologic disorders can be challenging and the differential diagnosis of a blistering eruption in the newborn period can be extensive. Several genodermatosis, such as bullous congenital ichthyosiform erythroderma (BCIE) and epidermolysis bullosa simplex (EBS), autoimmune bullous disorders, infectious diseases, sucking blisters, and bullous mastocytosis must be considered. We present a case of BCIE misdiagnosed as EBS and review characteristic clinical and histopathological features of each disorder as well as the basic approach to treatment. PMID:19930990

Alikhan, Ali; Farshidi, Dina; Shwayder, Tor

2009-01-01

475

Littoral cell angioma mimicking hepatic tumor  

PubMed Central

Littoral cell angioma is a rare vascular tumor of the spleen that was described by Falk et al. in 1991. Because of the limited number, untypical imaging manifestations, and lack of knowledge on this tumor type, these tumors are often misdiagnosed. In most cases, the tumor presents with multiple small hypoattenuating nodules in the spleen with delayed enhancement. However, solitary littoral cell angiomas have not been well described. We present the CT features of an unusual littoral cell angioma mimicking hepatic tumor.

Liang, Wenhua; Lu, Jingjing; Qin, Mingwei; Sang, Xinting

2012-01-01

476

Zinc-deficiency dermatitis in breast-fed infants  

Microsoft Academic Search

We report ten infants (mean gestational age: 30 weeks; range: 25 to 40 weeks) with zinc deficiency dermatitis who developed\\u000a erosive, impetiginized periorificial dermatitis at 10 weeks of age (corresponding to a mean gestational age of 41.4 weeks,\\u000a with a range of 36–44 weeks), but who were otherwise well. Cutaneous symptoms were initially misdiagnosed as eczema or impetigo\\u000a in 8\\/10 (80%) children who received either

Antonia Kienast; Bernhard Roth; Christiane Bossier; Christina Hojabri; Peter H. Hoeger

2007-01-01

477

Levodopa-Induced Facial Dystonia in a Case of Progressive Supranuclear Palsy  

PubMed Central

Progressive supranuclear palsy (PSP) is frequently misdiagnosed as other Parkinsonism because of clinical heterogeneity of PSP. We present here a case of a 67-year-old male patient with frontotemporal dementia-like cognitive impairment including language difficulties and abnormal behaviors. He showed severe facial dystonia after the levodopa treatment. Herein, we describe an unusual case of a patient presenting with PSP which, we believe could contribute to our knowledge about atypical leveodopa-induced facial dystonia in PSP.

Chung, Eun Joo; Kim, Sang Jin

2012-01-01

478

A retrospective study of prostate cancer cases mimicking urothelial cell carcinoma of the bladder  

PubMed Central

Background Prostate cancer (PCa) originating from the prostate base may intrude into the urinary bladder and may be misdiagnosed as bladder cancer. In this retrospective study, we reviewed the clinic data on PCa cases which were initially misdiagnosed as bladder cancer in order to identify diagnostic methods that would allow a better differential diagnosis for PCa. Methods Out of a total of 455 patients treated for PCa at our hospital between April 2003 and June 2011, 14 patients (3.1%) had been initially misdiagnosed as urinary bladder urothelial cell carcinoma. The clinical data on these 14 cases was retrieved and analyzed. Results Of the 14 patients, 11 patients were eventually diagnosed with PCa after MRI examination, and seven out of these had PCa with bladder neck invasion. Prostate needle biopsy or transurethral resection of prostate (TURP) revealed that all 14 patients had adenocarcinoma of prostate with Gleason scores ranging from 7 to 9. Nine patients received TURP for hematuria or lower urinary tract blockage. The mean follow-up was 37 months, during which six patients survived. Conclusions As clinical presentation and in emergency settings, prostate cancer originating from the prostate base can be confused with bladder cancer originating from the neck or the triangle region of the urinary bladder. Serum prostate specific antigen (PSA) levels and digital rectal examination, in combination with transrectal ultrasound (TRUS), MRI, and prostate needle biopsy are valuable tools for definitive differential diagnosis of the basal prostate cancer.

2013-01-01

479

Is there a cartesian renaissance of the mind or is it time for a new taxonomy for low responsive states?  

PubMed

The mass media have recently pointed out the likelihood of diagnostic errors in post-coma patients. Late recoveries of consciousness, even after 20 years, might indicate hidden misdiagnoses that are not corrected over a long period of time. The rate of misdiagnoses of patients in a vegetative state is very high when based on behavioral assessment strategies alone. An extremely restrictive motor repertoire, as occurs in locked-in patients, seems to be the major factor responsible for diagnostic confusion. Functional neuroimaging techniques are regarded as promising tools in unearthing covert awareness in behaviorally unresponsive patients who are unable to produce any motor output. However, unless we believe that these patients persistently live in an unconvincing Cartesian-like state, in which thinking and acting are mutually dissociated, we have to admit that a new taxonomy for low responsive states is called for. This taxonomy should take into account the possible syndromic overlap between disorders of consciousness and locked-in syndrome. We should suspect a "locked-in state" in behaviorally unresponsive patients unless we reach strong evidence that such is not the case; this is the only way to avoid dramatic misdiagnoses. PMID:21488720

Pistoia, Francesca; Sarà, Marco

2012-09-01

480

Anoxic seizures: self-terminating syncopes.  

PubMed

This review focuses on anoxic seizures induced by self terminating syncopes in the young. Anoxic seizures are nonepileptic events consequent upon abrupt interruption of the energy supply to metabolically active cerebral neurones. Anoxic seizures are the most common paroxysmal events misdiagnosed as epilepsy. Neurally mediated syncopes have numerous appellations, especially in the young. This proliferation of terminology likely results from uncertainty regarding pathophysiology. The most important type of self-limiting syncope from the point of view of diagnostic difficulty has been called neurocardiogenic or vasovagal syncope and reflex anoxic seizure, amongst other names: this review includes a video clip of such a child with prolonged asystole. It also includes a detailed case history emphasising the feelings of a patient with this type of syncope who was misdiagnosed as having epilepsy for many years. The second class of self-terminating syncope discussed and illustrated on video is the so-called breath-holding spell of young children. The third example illustrated is the compulsive Valsalva manoeuvre of individuals with autistic spectrum disorder, in which anoxic seizures - as shown on the video clips - are easily misdiagnosed as epileptic seizures, with unfortunate consequences. PMID:11313215

Stephenson, J B

2001-01-01

481

Description of Meloidoderita polygoni n. sp. (Nematoda: Meloidoderitidae) from USA and Observations on M. kirjanovae from Israel and USSR.  

PubMed

Meloidoderita polygoni n. sp. is described and illustrated from roots of smartweed (Polygonum hydropiperoides) from Beltsville, Maryland. This new species is similar to M. kirjanovae but differs especially in having larger spines on the cystoid bodies, females with the anus much closer to the vulva, and more posterior excretory pore. M. polygoni differs from M. safrica particularly in having females with a shorter stylet, a DGO much closer to base of stylet, greater distance between vulva and anus, and larger cystoid bodies. LM and SEM observations showed only three incisures in lateral fields of juveniles and males and no bursa in males. Morphometric data and illustrations are given for M. kirjanovae from mint (Mentha longifolia) in Israel and some details on a limited number of specimens from Armenian SSR. LM examination of juveniles from both these areas indicated only three incisures in lateral fields. Males from Israel had no detectable bursa and appeared to have only three incisures in lateral fields. (Males from Armenian SSR not observed.). PMID:19294022

Golden, A M; Handoo, Z A

1984-07-01

482

Control of Cdc14 activity coordinates cell cycle and development in C. elegans  

PubMed Central

Much of our understanding of the function and regulation of the Cdc14 family of dual-specificity phosphatases originates from studies in yeasts. In these unicellular organisms Cdc14 is an important regulator of M-phase events. In contrast, the Caenorhabditis elegans homolog, cdc-14, is not necessary for mitosis, rather it is crucial for G1/S regulation to establish developmental cell-cycle quiescence. Despite the importance of integrating cdc-14 regulation with development, the mechanisms by which this coordination occurs are largely unknown. Here, we demonstrate that several processes conspire to focus the activity of cdc-14. First, the cdc-14 locus can produce at least six protein variants through alternative splicing. We find that a single form, CDC-14C, is the key variant acting during vulva development. Second, CDC-14C expression is limited to a subset of cells, including vulva precursors, through post-transcriptional regulation. Lastly, the CDC-14C subcellular location, and thus its potential interactions with other regulatory proteins, is regulated by nucleocytoplasmic shuttling. We find that the active export of CDC-14C from the nucleus during interphase is dependent on members of the Cyclin D and Crm1 families. We propose that these mechanisms collaborate to restrict the activity of cdc-14 as central components of an evolutionarily conserved regulatory network to coordinate cell-cycle progression with development.

Roy, Sarah H.; Clayton, Joseph E.; Holmen, Jenna; Beltz, Eleanor; Saito, R. Mako

2011-01-01

483

Lymphatic mapping and sentinel node biopsy in gynecological cancers: a critical review of the literature  

PubMed Central

Although it does not have a long history of sentinel node evaluation (SLN) in female genital system cancers, there is a growing number of promising study results, despite the presence of some aspects that need to be considered and developed. It has been most commonly used in vulvar and uterine cervivcal cancer in gynecological oncology. According to these studies, almost all of which are prospective, particularly in cases where Technetium-labeled nanocolloid is used, sentinel node detection rate sensitivity and specificity has been reported to be 100%, except for a few cases. In the studies on cervical cancer, sentinel node detection rates have been reported around 80–86%, a little lower than those in vulva cancer, and negative predictive value has been reported about 99%. It is relatively new in endometrial cancer, where its detection rate varies between 50 and 80%. Studies about vulvar melanoma and vaginal cancers are generally case reports. Although it has not been supported with multicenter randomized and controlled studies including larger case series, study results reported by various centers around the world are harmonious and mutually supportive particularly in vulva cancer, and cervix cancer. Even though it does not seem possible to replace the traditional approaches in these two cancers, it is still a serious alternative for the future. We believe that it is important to increase and support the studies that will strengthen the weaknesses of the method, among which there are detection of micrometastases and increasing detection rates, and render it usable in routine clinical practice.

Ayhan, Ali; Celik, Husnu; Dursun, Polat

2008-01-01

484

Calcaridorylaimus castaneae sp. n. (Nematoda, Dorylaimidae) from Bulgaria with an identification key to the species of the genus  

PubMed Central

Abstract An unknown species belonging to the genusCalcaridorylaimus Andrássy, 1986 was collected from the litter of broadleaf forests dominated by Castanea sativa Mill. and mixed with Quercus daleshampii Ten. and Fagus sylvatica L. on Belasitsa Mountain, south-western Bulgaria. Calcaridorylaimus castaneae sp. n. is characterised by its long body (1.4–2.1 mm), lip region practically not offset, vulva transverse, short odontostyle (14.5–16 ?m) and tail (75.5–110.5 ?m, c=14.7–23.6; c’=2.9–4.4) in females and 38–46 ?m long spicules with small spur before their distant end in males. It is most similar to C. andrassyi Ahmad & Shaheen, 2004, but differs in having transverse vs pore-like vulva and shorter spicules (38–46 ?m vs 52–57 ?m). An identification key to the species of the genus Calcaridorylaimus is proposed. Phylogenetic analyses were performed on 18S and D2-D3 expansion domains of 28S rRNA genes by Neighbor-Joining, Maximum Likelihood and Bayesian Inference methods. The phylograms inferred from 18S sequences showed closest relationships of the new species with some species belonging to the genus Mesodorylaimus. However, insufficient molecular data for members of both genera do not allow the phylogenetic relationships of Calcaridorylaimus and the new species described herein to be elucidated.

Nedelchev, Sevdan; Elshishka, Milka; Lazarova, Stela; Radoslavov, Georgi; Hristov, Peter; Peneva, Vlada

2014-01-01

485

C. elegans Dopaminergic D2-Like Receptors Delimit Recurrent Cholinergic-Mediated Motor Programs during a Goal-Oriented Behavior  

PubMed Central

Caenorhabditis elegans male copulation requires coordinated temporal-spatial execution of different motor outputs. During mating, a cloacal circuit consisting of cholinergic sensory-motor neurons and sex muscles maintains the male's position and executes copulatory spicule thrusts at his mate's vulva. However, distinct signaling mechanisms that delimit these behaviors to their proper context are unclear. We found that dopamine (DA) signaling directs copulatory spicule insertion attempts to the hermaphrodite vulva by dampening spurious stimulus-independent sex muscle contractions. From pharmacology and genetic analyses, DA antagonizes stimulatory ACh signaling via the D2-li